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Mohan SD, Peterson S, Brenton JN, Carmichael SL, Virupakshaiah A, Rodriguez M, Tillema JM, Mar S, Rensel MR, Abrams A, Chitnis T, Benson L, Gorman M, Lotze T, Shukla N, Graves J, Aaen G, Casper TC, Waubant E. Association of nutritional intake with clinical and imaging activity in pediatric multiple sclerosis. Mult Scler 2024; 30:1056-1065. [PMID: 39078111 DOI: 10.1177/13524585241261556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
BACKGROUND Understanding nutrition's role in multiple sclerosis (MS) can guide recommendations and intervention-based studies. OBJECTIVE Evaluate the association between nutrition and pediatric-onset MS outcomes. METHODS Prospective longitudinal multicenter study conducted as part of the US Network of Pediatric MS centers. Predictors were collected using a food screener estimating intake of various dietary food groups (e.g. dairy and fruits) and additional calculated indices (e.g. Healthy Eating Index (HEI)). Outcomes included time-from-enrollment to clinical relapse, new magnetic resonance imaging (MRI) T2 lesions, and Expanded Disability Status Scale (EDSS) increase. RESULTS 353 children with MS were enrolled (mean ± SD age 15.4 ± 2.9, follow-up 3.9 ± 2.6 years). Multivariable analysis demonstrated that increased dairy by 50% of recommended intake was associated with increased relapse risk by 41% (adjusted hazard ratio (HR) 1.41, 95% CI 1.07-1.86), and risk of T2 progression by 40% (1.40, 1.12-1.74). Increased intake of fruit or vegetable above recommended, and every five-point HEI increase decreased relapse risk by 25% (0.75, 0.60-0.95), 45% (0.55, 0.32-0.96), and 15% (0.84, 0.74-0.96), respectively. No associations were found with EDSS. CONCLUSION This work supports the influence of dietary intake on MS course, particularly with dairy intake. Future prospective study is required to establish causation.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mary R Rensel
- Mayo Clinic Pediatric MS Center, Mayo Clinic, Rochester, MN, USA
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Barbero Mazzucca C, Scotti L, Comi C, Vecchio D, Chiocchetti A, Cappellano G. The Role of Diet in Multiple Sclerosis Onset: A Prospective Study Using UK Biobank. Nutrients 2024; 16:1746. [PMID: 38892680 PMCID: PMC11174354 DOI: 10.3390/nu16111746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
Multiple sclerosis (MS) is a debilitating autoimmune condition primarily affecting young adults, and its rise is evident globally. Despite this, its precise etiology remains elusive. Both genetic and environmental factors contribute to MS susceptibility; however, the link between diet and MS lacks substantial evidence due to limited large-scale studies. We exploited the UK Biobank resources to explore the nexus between diet, lifestyle, and MS risk. The dietary and lifestyle habits of MS incident cases, derived from a general food frequency questionnaire (FFQ) completed by all participants at study enrollment, were compared to those of subjects who did not develop MS during the follow-up. Our findings suggest the protective role of moderate oily fish consumption and weekly alcohol intake. Furthermore, by analyzing food intake data obtained through 24 h recall, completed by a subset of participants, we found a protective, though non-significant, trend of an increased adherence to the Mediterranean diet (MD). These findings, derived from the analysis of the UK Biobank and representing an unprecedented approach for this inquiry, warrant further exploration and integration in future research.
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Affiliation(s)
- Camilla Barbero Mazzucca
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases-IRCAD, Università del Piemonte Orientale, 28100 Novara, Italy; (C.B.M.); (G.C.)
- Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, 28100 Novara, Italy
| | - Lorenza Scotti
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (L.S.); (C.C.); (D.V.)
| | - Cristoforo Comi
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (L.S.); (C.C.); (D.V.)
- MS Centre, Azienda Ospedaliero-Universitaria Maggiore della Carità, 28100 Novara, Italy
- Department of Neurology, University of Piemonte Orientale, 28100 Novara, Italy
- Neurology Unit, S. Andrea Hospital, Department of Translational Medicine, University of Piemonte Orientale, 13100 Vercelli, Italy
| | - Domizia Vecchio
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (L.S.); (C.C.); (D.V.)
- MS Centre, Azienda Ospedaliero-Universitaria Maggiore della Carità, 28100 Novara, Italy
- Department of Neurology, University of Piemonte Orientale, 28100 Novara, Italy
| | - Annalisa Chiocchetti
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases-IRCAD, Università del Piemonte Orientale, 28100 Novara, Italy; (C.B.M.); (G.C.)
- Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, 28100 Novara, Italy
| | - Giuseppe Cappellano
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases-IRCAD, Università del Piemonte Orientale, 28100 Novara, Italy; (C.B.M.); (G.C.)
- Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, 28100 Novara, Italy
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Morin CR, Baeva ME, Hollenberg MD, Brain MC. Milk and multiple sclerosis: A possible link? Mult Scler Relat Disord 2024; 83:105477. [PMID: 38308914 DOI: 10.1016/j.msard.2024.105477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/07/2024] [Accepted: 01/26/2024] [Indexed: 02/05/2024]
Abstract
Despite having been formally defined over 150 years ago, the etiology of multiple sclerosis (MS) is still relatively unknown. However, it is now recognized as a multifactorial disease in which genetics, infection, immune function, and environment play a role. We propose an additional piece to the puzzle: milk. In this review, milk is highlighted as a potential risk factor for MS. We examine the overall correlation between bovine milk consumption and the incidence of MS. We then discuss possible mechanisms that may explain the positive association between milk consumption and the development of MS. For instance, butyrophilin (BTN), a milk glycoprotein, can provide molecular mimicry of myelin oligodendrocyte glycoprotein and induce an autoinflammatory response against myelin. Other milk components such as casein, gangliosides, xanthine oxidase, and saturated fats are also analyzed for their potential involvement in the pathophysiology of MS. Finally, we fit milk alongside other well known risk factors of MS: vitamin D levels, Epstein Barr virus infection, and gut dysbiosis. In conclusion, this review summarizes potential mechanisms linking milk as an underappreciated potential risk factor for the development of MS.
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Affiliation(s)
- Caleb R Morin
- University of Calgary Cumming School of Medicine, Calgary, AB T2N 4N1, Canada
| | | | - Morley D Hollenberg
- Department of Physiology & Pharmacology, University of Calgary Cumming School of Medicine, Calgary, AB T2N 4N1, Canada
| | - Michael C Brain
- Department of Biochemistry and Molecular Biology, University of Calgary Cumming School of Medicine, Calgary, AB T2N 4N1, Canada
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Ahmed A, Rawshan AEM, Tishe ZH, Shawkat S, Popy MN, Shohag MH, Hossain M, Mostaid MS. Association of CD58 rs12044852 and rs2300747 polymorphisms with the risk of multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord 2024; 82:105411. [PMID: 38176285 DOI: 10.1016/j.msard.2023.105411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/03/2023] [Accepted: 12/23/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE Multiple sclerosis is a serious neurodegenerative disorder that causes disability in young adults. Genetic predisposition of multiple sclerosis is well documented and several single nucleotide polymorphisms (SNPs) of the CD58 were found to be associated with this disease. This systematic review and meta-analysis were done with the aim of finding the association between CD58 gene SNPs (rs12044852 and rs2300747) and the risk of multiple sclerosis (MS). METHOD A comprehensive search was done in PubMed, Google Scholar, Embase, and MSGene.org to find the relevant data. Our search yielded 13 relevant publications which were included for meta-analysis consisting of 5194 cases and 5766 controls. All the statistical analysis was conducted using meta and metafor packages in R studio. The odds ratio (OR) along with 95 % confidence intervals and p values were determined using the fixed effects and random effects model. The I2 test was done to measure heterogeneity. Subgroup analysis was performed along with analysis for publication bias. RESULTS We found significant association for both rs12044852 (allelic, dominant, over-dominant, heterozygous, and homozygous models) and rs2300747 (allelic, dominant, over-dominant, heterozygous models) with multiple sclerosis. Both the SNPs provided a protective effect for multiple sclerosis. Subgroup analysis indicated that rs12044852 polymorphism provided a protective effect in both Asians and Caucasians. However, for rs2300747, the Asian population showed no statistically significant association with the risk of MS. CONCLUSION Polymorphism of rs12044852 and rs2300747 of the CD58 gene provided a protective effect for multiple sclerosis. The protective effect is more prominent in Caucasian populations compared to Asians.
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Affiliation(s)
- Ashfaq Ahmed
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Plot 15, Block B, Bashundhara R/A, Dhaka 1229, Bangladesh
| | | | - Zasia Hossain Tishe
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Plot 15, Block B, Bashundhara R/A, Dhaka 1229, Bangladesh
| | - Sanjana Shawkat
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Plot 15, Block B, Bashundhara R/A, Dhaka 1229, Bangladesh
| | - Meherun Nessa Popy
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Plot 15, Block B, Bashundhara R/A, Dhaka 1229, Bangladesh
| | - Md Hasanuzzaman Shohag
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Plot 15, Block B, Bashundhara R/A, Dhaka 1229, Bangladesh
| | - Murad Hossain
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Plot 15, Block B, Bashundhara R/A, Dhaka 1229, Bangladesh
| | - Md Shaki Mostaid
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Plot 15, Block B, Bashundhara R/A, Dhaka 1229, Bangladesh.
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Temperley IA, Seldon AN, Reckord MA, Yarad CA, Islam FT, Duncanson K, Lea RA, Lechner-Scott J, Maltby VE. Dairy and gluten in disease activity in multiple sclerosis. Mult Scler J Exp Transl Clin 2023; 9:20552173231218107. [PMID: 38130338 PMCID: PMC10734333 DOI: 10.1177/20552173231218107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
Background Many diets promoted specifically for multiple sclerosis have been suggested to improve disease activity. Dairy and gluten are two components for which the recommendations vary between these diets. Existing research into the association between these dietary components and disease activity has been conflicting. Objective To explore the relationship between dairy and gluten intake and disease activity in multiple sclerosis over a 2-year period, using no evidence of disease activity (NEDA) 3 status. Methods 186 participants' dairy and gluten intake was retrospectively estimated over 2 years using a dairy and gluten dietary screener. Estimated dairy and gluten intake was compared to disease activity, indicated by no evidence of disease activity 3 status, and quality of life, assessed by the Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire. Results No significant association was found between mean estimated dairy or gluten intake and NEDA 3 status (p = 0.15 and 0.60, respectively). Furthermore, there was no significant relationship between dairy or gluten intake and MusiQoL) scores (p = 0.11 and 0.51, respectively). Conclusion Whilst we cannot rule out modest benefits due to our small sample size, we found that neither dairy nor gluten intake was associated with disease activity or quality of life in this study.
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Affiliation(s)
- Isabel A Temperley
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Alexandra N Seldon
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Madeline Aw Reckord
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Claudia A Yarad
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Farihah T Islam
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Kerith Duncanson
- Centre of Research Excellence in Digestive Health, University of Newcastle, Callaghan, NSW, Australia
| | - Rodney A Lea
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Centre for Genomics and Personalised Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jeannette Lechner-Scott
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Department of Neurology, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Vicki E Maltby
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Department of Neurology, John Hunter Hospital, New Lambton Heights, NSW, Australia
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Loonstra FC, de Ruiter LRJ, Schoonheim MM, Moraal B, Strijbis EMM, de Jong BA, Uitdehaag BMJ. The role of diet in multiple sclerosis onset and course: results from a nationwide retrospective birth-year cohort. Ann Clin Transl Neurol 2023; 10:1268-1283. [PMID: 37421227 PMCID: PMC10424663 DOI: 10.1002/acn3.51788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/17/2023] [Accepted: 04/27/2023] [Indexed: 07/10/2023] Open
Abstract
OBJECTIVE To examine (1) the association between childhood diet and developing MS, age of onset and onset type and (2) the association between diet at age 50 and disability and MRI volumes in people with MS (PwMS). METHODS The study enrolled 361 PwMS born in 1966 and 125 age- and sex-matched healthy controls (HCs). Information on individual dietary components (fruit, vegetables, red meat, oily fish, whole-grain bread and candy, snacks and fast food) and MS risk factors at the age of 10 and 50 years were collected using questionnaires. Overall diet quality score was calculated for each participant. Multivariable regression analyses were used to evaluate the association between diet at childhood and developing MS, age of onset and onset type and to evaluate diet at age 50, disability and MRI outcomes. RESULTS Poorer overall diet quality and individual dietary components during childhood (less whole-grain bread, more candy, snacks and fast food and oily fish) were associated with developing MS and onset type (all p < 0.05), but not with the age of onset. Fruit consumption at age 50 was associated with lower disability (Q3 vs. Q1: -0.51; 95% CI: -0.89 to -0.13). Furthermore, several individual dietary components at age 50 were associated with MRI volumetric measures. Higher-diet quality at age 50 was only associated with lower lesion volumes in PwMS (Q2 vs. Q1: -0.3 mL; 95% CI: -0.5 to -0.02). INTERPRETATION We demonstrate significant associations between dietary factors in childhood and developing MS, age of onset and onset type and between dietary factors at age 50 and disability and MRI-derived volumes.
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Affiliation(s)
- Floor C. Loonstra
- MS Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmcAmsterdamThe Netherlands
| | - Lodewijk R. J. de Ruiter
- MS Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmcAmsterdamThe Netherlands
- MS Center Amsterdam, Anatomy and NeurosciencesVrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmcAmsterdamThe Netherlands
| | - Menno M. Schoonheim
- MS Center Amsterdam, Anatomy and NeurosciencesVrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmcAmsterdamThe Netherlands
| | - Bastiaan Moraal
- MS Center Amsterdam, Radiology and Nuclear MedicineVrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmcAmsterdamThe Netherlands
| | - Eva M. M. Strijbis
- MS Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmcAmsterdamThe Netherlands
| | - Brigit A. de Jong
- MS Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmcAmsterdamThe Netherlands
| | - Bernard M. J. Uitdehaag
- MS Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmcAmsterdamThe Netherlands
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Lan T, Park Y, Colditz GA, Liu J, Wang M, Wu K, Giovannucci E, Sutcliffe S. Adolescent dietary patterns in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study. Br J Cancer 2023; 128:57-62. [PMID: 36316560 PMCID: PMC9814153 DOI: 10.1038/s41416-022-02035-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Although adolescent diet has been proposed to contribute to prostate cancer (PCa) development, no studies have investigated the relation between adolescent dietary patterns and PCa risk or mortality. METHODS Using data from 164,079 men in the NIH-AARP Diet and Health Study, we performed factor analysis to identify dietary patterns at ages 12-13 years and then used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of total (n = 17,861), non-advanced (n = 15,499), advanced (n = 2362), and fatal PCa (n = 832). RESULTS Although not entirely consistent across analyses, a higher adolescent plant-based pattern (characterised by vegetables, fruits, and dark bread) score was associated with slightly reduced risks of total (fully adjusted HRQ5vs.Q1 = 0.93, 95% CI: 0.89-0.98, p trend=0.003) and non-advanced PCa (HR = 0.91, 95% CI: 0.87-0.96, p trend<0.001), whereas no associations were observed for advanced or fatal PCa, or for Western modern (characterised by sweets, processed meat, beef, cheese, and pizza) or Western traditional (characterised gravy, eggs, potatoes and white bread) patterns. CONCLUSION We found evidence to support a modest, protective role for a plant-based dietary pattern during adolescence on PCa risk. If confirmed in future studies, our findings may help to inform the development of new, primary prevention strategies for PCa.
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Affiliation(s)
- Tuo Lan
- Department of Occupational and Environmental Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jingxia Liu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Molin Wang
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Kana Wu
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.
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Dieu DYR, Dunlop E, Daly A, Lucas RM, Probst Y, Black LJ. Total Dairy Consumption Is Not Associated With Likelihood of a First Clinical Diagnosis of Central Nervous System Demyelination. Front Neurol 2022; 13:888559. [PMID: 35645978 PMCID: PMC9136160 DOI: 10.3389/fneur.2022.888559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022] Open
Abstract
Background The evidence associating consumption of dairy products and risk of MS is contradictory and inconclusive. Objective To test associations between dairy consumption and the likelihood of a first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to MS. Methods We used data from the 2003–2006 Ausimmune Study, a population-based Australian, multicentre, matched case-control study (272 cases, 519 controls). Total dairy consumption (servings/day) was calculated by summing consumption of milk, cheese and yogurt. Covariate-adjusted treatment effects using augmented inverse probability weighting was used to test for associations with FCD. We conducted sensitivity analyses in the subset of participants who had had a classic first demyelinating event (FDE), defined as a single, first episode of symptoms suggestive of CNS demyelination. Results There were no statistically significant associations between total dairy consumption (per one serving/day) and FCD (adjusted OR 1.00; 95% CI 0.93, 1.07; p = 0.979). However, yogurt consumption (vs. no yogurt consumption) was associated with an 11% decreased likelihood of FDE (adjusted OR 0.89; 95% CI 0.89, 0.79; p = 0.046). Conclusion While total dairy consumption was not associated with FCD in this Australian case-control study, yogurt consumption was associated with reduced likelihood of FDE.
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Affiliation(s)
| | - Eleanor Dunlop
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Alison Daly
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Robyn M. Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia
| | - Yasmine Probst
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Lucinda J. Black
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA, Australia
- *Correspondence: Lucinda J. Black
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Alkhawajah NM, Aljarallah S, Hussain-Alkhateeb L, Almohaini MO, Muayqil TA. Waterpipe Tobacco Smoking and Other Multiple Sclerosis Environmental Risk Factors. Neuroepidemiology 2021; 56:97-103. [PMID: 34872078 DOI: 10.1159/000521223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/25/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction There are a number of well-established risk factors for multiple sclerosis (MS). Other factors however, showed conflicting or non-consistent results. Here we examine some factors that are unique to or more practiced in Saudi Arabia (SA) and the Arab region such as waterpipe tobacco smoking (WTS), face veiling, raw milk (RM), and camel milk (CM) consumption, tuberculosis (TB) infection in addition to other traditional factors. Methods This is a sex and age matched case-control study in which we used a structured questionnaire to examine the relation between a number of factors and exposures and the risk of MS. Three hundred MS patients and 601 controls were included. Data was analyzed across different statistical models using logistic regression adjusting for age, sex, marital status, duration of breastfeeding, age first joining school, coffee consumption, and face exposure. Results Cigarette smoking [OR = 1.79, (95% CI 1.01-3.17), P =0.047)], WTS [OR = 2.25, (95% CI 1.21-4.15), P =0.010)], and CM consumption [OR = 2.50, (95% CI 1.20-5.21), P =0.014)] increased the risk of MS. While performing hajj [OR = 0.47, (95% CI 0.34-0.67), P =0.001)], TB infection [OR = 0.29, (95% CI 0.11-0.78), P =0.015)], face veiling [OR = 0.32, (95% CI 0.23-0.47), P =0.001)] and coffee consumption [OR =0.67, (95% CI 0.49-0.89), P =0.008)], appeared to be associated with decreased risk. No association was found between fast food, processed meat, soft drinks, animal milk (other than camel) or RM consumption and the risk of MS. Conclusion The results of this case-control study confirm that different means of tobacco smoking are associated with increased risk of MS. It also sheds more light on the complex association between infections and MS.
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Affiliation(s)
- Nuha M Alkhawajah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Division of Neurology, Department of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Salman Aljarallah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Division of Neurology, Department of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Laith Hussain-Alkhateeb
- Global Health, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mohammad Osama Almohaini
- Division of Neurology, Department of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Taim A Muayqil
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Division of Neurology, Department of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
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Abstract
PURPOSE OF REVIEW Dietary interventions may play a role in the pathophysiology of common neurological disorders such as Alzheimer's disease, Parkinson's disease, stroke, migraines, multiple sclerosis, and epilepsy. This article describes the most common and impactful dietary regimens for commonly encountered neurological disorders. RECENT FINDINGS Plant-based, low-fat, high-fiber diets, rich in antioxidants and other lifestyle interventions may reduce the burden and disability of common neurological disorders. The ketogenic diet, the diet of choice for the treatment of refractory epilepsy, is such an example. Diverse neurological disorders demonstrate several common pathophysiological mechanisms including increased oxidative stress, neuroinflammation, and disrupted metabolism. Dietary interventions can potentially influence these pathophysiological processes and thus favorably alter clinical outcomes. Adequate dietary choices should be considered as part of a continuum of healthy lifestyle choices.
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Katz Sand IB, Fitzgerald KC, Gu Y, Brandstadter R, Riley CS, Buyukturkoglu K, Leavitt VM, Krieger S, Miller A, Lublin F, Klineova S, Fabian M, Sumowski JF. Dietary factors and MRI metrics in early Multiple Sclerosis. Mult Scler Relat Disord 2021; 53:103031. [PMID: 34077830 DOI: 10.1016/j.msard.2021.103031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite significant interest in diet by the MS community, research on this topic is limited; there are no published studies evaluating associations between diet and neuroimaging in MS. METHODS We utilized baseline data from the RADIEMS cohort of early MS (diagnosed <5.0 years, n=180). Participants underwent brain MRIs to derive normalized total gray and thalamic volumes, T2 lesion volume, and white matter microstructural integrity of normal appearing white matter (NAWM). Participants completed food frequency questionnaires (FFQ) from which we calculated adherence scores to pre-specified dietary patterns including the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. We evaluated intake of the following pre-specified dietary components: fruits, vegetables, legumes, nuts, whole grains, dairy, fried foods, processed meats, and fat intake. We used multivariable-adjusted linear regression to evaluate MRI metrics versus dietary measures. RESULTS MIND diet score was associated with thalamic volume; individuals in the highest quartile of MIND diet scores had greater thalamic volumes versus those in the lowest quartile (Q4 vs. Q1: 1.03mL; 95%CI: 0.26mL, 1.79mL; p<0.01). For individual food/nutrients, higher intakes of full-fat dairy were associated with lower T2 lesion volumes (Q4 vs. Q1: -0.93mL; 95%CI: -1.51mL, -0.35ml; p<0.01). Higher intakes of marine omega-3 fatty acids were associated with greater NAWM microstructural integrity (Q4 vs. Q1: 0.40; 95%CI: 0.03, 0.76; p=0.04). Other foods/nutrients were not associated with MRI outcomes. CONCLUSIONS In this first study focused on neuroimaging and diet in MS, we note significant associations in a cross-sectional early MS cohort. Longitudinal follow-up of imaging/clinical outcomes will provide additional insights.
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Affiliation(s)
- I B Katz Sand
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States.
| | - Kathryn C Fitzgerald
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Yian Gu
- Department of Neurology, Columbia University Irving Medical Center, New York City, United States; Department of Neurology, Department of Epidemiology, The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, United States
| | - Rachel Brandstadter
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States; Department of Neurology, University of Pennsylvania, United States
| | - Claire S Riley
- Department of Neurology, Columbia University Irving Medical Center, New York City, United States
| | - Korhan Buyukturkoglu
- Department of Neurology, Columbia University Irving Medical Center, New York City, United States
| | - Victoria M Leavitt
- Department of Neurology, Columbia University Irving Medical Center, New York City, United States
| | - Stephen Krieger
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States
| | - Aaron Miller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States
| | - Fred Lublin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States
| | - Sylvia Klineova
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States
| | - Michelle Fabian
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States
| | - James F Sumowski
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States
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12
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Omraninava M, Mehranfar S, Vahedi P, Razi B, Imani D, Aslani S, Feyzinia S. Association between IL7 Receptor Alpha (Il7ra) gene rs6897932 polymorphism and the risk of Multiple Sclerosis: A meta-regression and meta-analysis. Mult Scler Relat Disord 2020; 48:102687. [PMID: 33348212 DOI: 10.1016/j.msard.2020.102687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/02/2020] [Accepted: 12/10/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND In this systematic review and meta-analysis, we aimed to find a consistent conclusion for the association between the interleukin 7 receptor alpha (IL7RA) gene rs6897932 single nucleotide polymorphism (SNP) and multiple sclerosis (MS) risk. METHODS Here, we performed a comprehensive systematic search in PubMed, Scopus, and Web of Science to find relevant studies published before November 2020 investigating the association between rs6897932 SNP and MS risk. In the pooled analysis, we determined the odds ratio (OR) and the corresponding 95% confidence interval (CI) for the association level between rs6897932 SNP and the risk of MS. RESULTS In the current meta-analysis 33 case-control studies (30 articles) containing 19351 patients and 21005 healthy controls certify the inclusion criteria. According to the pooled analysis, a statistically significant association of IL7RA gene rs6897932 SNP with MS risk was found across recessive model (OR= 0.84, 95% CI= 0.77-0.92, P< 0.001, FEM), allelic model (OR= 0.91, 95% CI= 0.85-0.99, P= 0. 02, REM), TT vs. CC model (OR= 0.79, 95% CI= 0.67-0.93, P= 0.005, REM). Moreover, the subgroup analysis based on the ethnicity indicated a negative significant association in Europeans; dominant model (OR= 0.88, 95% CI= 0.78-1.01, P= 0.06, REM), recessive model (OR= 0.79, 95% CI= 0.71-0.88, P< 0.001, REM), allelic model (OR= 0.88, 95% CI= 0.81-0.96, P= 0.003, REM), TT vs. CC model (OR= 0.74, 95% CI= 0.61-0.88, P<0.001, REM) models. Nonetheless, no significant association was detected in Asians and Americans. CONCLUSIONS IL7RA gene rs6897932 SNP decreases MS susceptibility in overall population and Europeans.
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Affiliation(s)
- Melodi Omraninava
- Department of Infectious Disease, Faculty of Medical Sciences, Sari Branch, Islamic Azad University, Sari, Iran
| | - Sahar Mehranfar
- Department of Genetics and Immunology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran; Social Determinant of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Parviz Vahedi
- Department of anatomical sciences, Maragheh University of Medical Sciences. Maragheh, Iran
| | - Bahman Razi
- Department of Hematology, School of Medicine, Tarbiat Modares University, Tehran, Iran
| | - Danyal Imani
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Aslani
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Feyzinia
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Rahat Breath and Sleep Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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13
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Lan T, Park Y, Colditz GA, Liu J, Wang M, Wu K, Giovannucci E, Sutcliffe S. Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study. Cancer Causes Control 2020; 31:891-904. [PMID: 32743740 DOI: 10.1007/s10552-020-01330-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 07/24/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Although a growing body of evidence supports an early-life contribution to prostate cancer (PCa) development, few studies have investigated early-life diet, and only three have examined early-life dairy product intake, a promising candidate risk factor because of its known/suspected influence on insulin-like growth factor levels and height. METHODS We used recalled dietary data from 162,816 participants in the NIH-AARP Diet and Health Study to investigate associations for milk, cheese, ice cream, total dairy, and calcium intake at ages 12-13 years with incident total (n = 17,729), advanced (n = 2,348), and fatal PCa (n = 827) over 14 years of follow-up. We calculated relative risks (RRs) and 95% confidence intervals (CIs) by Cox proportional hazards regression. RESULTS We observed suggestive positive trends for milk, dairy, and calcium intake with total and/or advanced PCa (p-trends = 0.016-0.148). These trends attenuated after adjustment for additional components of adolescent diet, particularly red meat and vegetables/potatoes. In contrast, suggestive inverse trends were observed for cheese and ice cream intake with total and/or advanced PCa (p-trends = 0.043-0.153), and for milk, dairy, and calcium intake with fatal PCa (p-trend = 0.045-0.117). CONCLUSION Although these findings provide some support for a role of adolescent diet in increasing PCa risk, particularly for correlates of milk intake or overall dietary patterns, our protective findings for cheese and ice cream intake with PCa risk and mortality, and for all dairy products with PCa mortality, suggest alternative explanations, such as the influence of early-life socioeconomic status, and increased PCa screening, earlier detection, and better PCa care.
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Affiliation(s)
- Tuo Lan
- Department of Occupational and Environmental Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jingxia Liu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Molin Wang
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Kana Wu
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA.,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. .,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.
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14
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Falahatian M. The Effects of Different Kinds of Nutrition and Functional Foods on Multiple Sclerosis. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401316666200129115858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It is an assumption that different kinds of nutrition, diet, and functional foods might have
different positive or negative effects on multiple sclerosis (MS), a neuroinflammatory disease of the
central nervous system (CNS). This brief paper involved a study on various kinds of nutrition including
salt, fat, dairy, fruit, and vegetables. At the end of this study, appropriate diets were evaluated for
MS patients. Based on previous studies both on animal models and on MS patients, excessive dietary
salt intake and animal fat had worsening effects on MS patients but fruit and vegetable intake helped
the remission of MS and decreased the risk of developing it. There were, of course, conflicting results
in different studies over the role of some nutrition in MS and future studies on larger numbers
of cases were required to collect reliable results. As a result, at the end of this study and based on literature,
it is suggested that a diet should be programmed by nutritionists containing fewer salt, fat,
and dairy intake and more fruits and vegetables for MS patients in order to better management of the
disease.
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Affiliation(s)
- Masih Falahatian
- Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Smagina IV, Lunev KV, Elchaninova SA. Vitamin D status in patients with multiple sclerosis: an association with insolation, disease course, and HLA-DRB1 gene polymorphism. ACTA ACUST UNITED AC 2020. [DOI: 10.14412/2074-2711-2020-3-63-68] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- I. V. Smagina
- Altai State Medical University, Ministry of Health of Russia
| | - K. V. Lunev
- Altai State Medical University, Ministry of Health of Russia
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16
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Valburg C, Sonti A, Stern JN, Najjar S, Harel A. Dietary factors in experimental autoimmune encephalomyelitis and multiple sclerosis: A comprehensive review. Mult Scler 2020; 27:494-502. [PMID: 32406797 DOI: 10.1177/1352458520923955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Dietary intervention in multiple sclerosis carries potential therapeutic implications. While studies utilizing animal models of multiple sclerosis (MS) have demonstrated intriguing findings, well-designed clinical trials are few in number. OBJECTIVE The objective of this study is to review the animal model and clinical literature regarding dietary factors in experimental autoimmune encephalitis (EAE) and MS. METHODS This manuscript provides a comprehensive review of current animal model and clinical knowledge related to dietary factors in MS. RESULTS While there is currently little data for any specific diet in MS, there is growing evidence that certain dietary factors may influence the disease. CONCLUSIONS Definitive information regarding dietary factors as a modifiable risk factor in MS will require larger randomized clinical trials.
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Affiliation(s)
- Claire Valburg
- Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Anup Sonti
- Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Joel Nh Stern
- Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA/Institute of Molecular Medicine, The Feinstein Institute for Medical Research, Manhasset, NY, USA/Department of Neurology, Lenox Hill Hospital, New York, NY, USA
| | - Souhel Najjar
- Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA/Institute of Molecular Medicine, The Feinstein Institute for Medical Research, Manhasset, NY, USA/Department of Neurology, Lenox Hill Hospital, New York, NY, USA
| | - Asaff Harel
- Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA/Institute of Molecular Medicine, The Feinstein Institute for Medical Research, Manhasset, NY, USA/Department of Neurology, Lenox Hill Hospital, New York, NY, USA
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17
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Gut microbiota depletion from early adolescence alters adult immunological and neurobehavioral responses in a mouse model of multiple sclerosis. Neuropharmacology 2019; 157:107685. [DOI: 10.1016/j.neuropharm.2019.107685] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 02/06/2023]
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18
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Zur Hausen H, Bund T, de Villiers EM. Infectious Agents in Bovine Red Meat and Milk and Their Potential Role in Cancer and Other Chronic Diseases. Curr Top Microbiol Immunol 2019; 407:83-116. [PMID: 28349283 DOI: 10.1007/82_2017_3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Red meat and dairy products have frequently been suggested to represent risk factors for certain cancers, chronic neurodegenerative diseases, and autoimmune and cardiovascular disorders. This review summarizes the evidence and investigates the possible involvement of infectious factors in these diseases. The isolation of small circular single-stranded DNA molecules from serum and dairy products of Eurasian Aurochs (Bos taurus)-derived cattle, obviously persisting as episomes in infected cells, provides the basis for further investigations. Gene expression of these agents in human cells has been demonstrated, and frequent infection of humans is implicated by the detection of antibodies in a high percentage of healthy individuals. Epidemiological observations suggest their relationship to the development multiple sclerosis, to heterophile antibodies, and to N-glycolylneuraminic acid (Neu5Gc) containing cell surface receptors.
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Affiliation(s)
- Harald Zur Hausen
- Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
| | - Timo Bund
- Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
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19
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Zendehdel A, Arefi M. Molecular evidence of role of vitamin D deficiency in various extraskeletal diseases. J Cell Biochem 2019; 120:8829-8840. [PMID: 30609168 DOI: 10.1002/jcb.28185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/12/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Role of vitamin D is not only limited to skeletal system but various other systems of the body, such as immune system, endocrine system, and cardiopulmonary system. MATERIALS AND METHODS It is supported by the confirmations of systems-wide expression of vitamin D receptor (VDR), endocrinal effect of calcitriol, and its role in immune responses. RESULTS Expression of VDR in various systems, immunoregulatory and hormonal response of vitamin D and deficiency of vitamin D may establish various pathologies in the body. CONCLUSION This review provides molecular evidence of relation of vitamin D with extra skeletal.
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Affiliation(s)
- Abolfazl Zendehdel
- Department of Geriatric Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Arefi
- Department of Clinical Toxicology, School of Medicine, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
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20
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Abstract
PURPOSE OF REVIEW This review seeks to examine current research related to the role of diet in multiple sclerosis (MS). RECENT FINDINGS Recent research in preclinical models, epidemiologic studies, and limited prospectively followed cohorts provide preliminary evidence that dietary factors influence MS incidence, disease course, and symptomatology. Current evidence for the effects of fatty acids, fruits and vegetables, whole grains, dairy, and salt are reviewed. Dietary patterns including overall diet quality, caloric restriction, McDougall diet, Paleolithic diet, and Mediterranean diet are discussed. Hypotheses regarding potential mechanistic connections underlying observed effects are also presented. Several individual dietary components and patterns demonstrate potential for significant impact in MS. Definitive answers regarding the ability of diet to act as a disease modifier in MS will ultimately require large-scale clinical trials. Continued prospective studies and clinical trials to further advance this line of research are warranted.
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Affiliation(s)
- Ilana Katz Sand
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, Suite 1138, New York, NY, 10029, USA.
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21
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Lucas RM, Rodney Harris RM. On the Nature of Evidence and 'Proving' Causality: Smoking and Lung Cancer vs. Sun Exposure, Vitamin D and Multiple Sclerosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081726. [PMID: 30103527 PMCID: PMC6121485 DOI: 10.3390/ijerph15081726] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 07/20/2018] [Accepted: 08/07/2018] [Indexed: 12/19/2022]
Abstract
If environmental exposures are shown to cause an adverse health outcome, reducing exposure should reduce the disease risk. Links between exposures and outcomes are typically based on 'associations' derived from observational studies, and causality may not be clear. Randomized controlled trials to 'prove' causality are often not feasible or ethical. Here the history of evidence that tobacco smoking causes lung cancer-from observational studies-is compared to that of low sun exposure and/or low vitamin D status as causal risk factors for the autoimmune disease, multiple sclerosis (MS). Evidence derives from in vitro and animal studies, as well as ecological, case-control and cohort studies, in order of increasing strength. For smoking and lung cancer, the associations are strong, consistent, and biologically plausible-the evidence is coherent or 'in harmony'. For low sun exposure/vitamin D as risk factors for MS, the evidence is weaker, with smaller effect sizes, but coherent across a range of sources of evidence, and biologically plausible. The association is less direct-smoking is directly toxic and carcinogenic to the lung, but sun exposure/vitamin D modulate the immune system, which in turn may reduce the risk of immune attack on self-proteins in the central nervous system. Opinion about whether there is sufficient evidence to conclude that low sun exposure/vitamin D increase the risk of multiple sclerosis, is divided. General public health advice to receive sufficient sun exposure to avoid vitamin D deficiency (<50 nmol/L) should also ensure any benefits for multiple sclerosis, but must be tempered against the risk of skin cancers.
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Affiliation(s)
- Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra 2600, Australia.
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth 6009, Australia.
| | - Rachael M Rodney Harris
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra 2600, Australia.
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22
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Vitamin D in Neurological Diseases: A Rationale for a Pathogenic Impact. Int J Mol Sci 2018; 19:ijms19082245. [PMID: 30065237 PMCID: PMC6121649 DOI: 10.3390/ijms19082245] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 07/25/2018] [Accepted: 07/26/2018] [Indexed: 12/22/2022] Open
Abstract
It is widely known that vitamin D receptors have been found in neurons and glial cells, and their highest expression is in the hippocampus, hypothalamus, thalamus and subcortical grey nuclei, and substantia nigra. Vitamin D helps the regulation of neurotrophin, neural differentiation, and maturation, through the control operation of growing factors synthesis (i.e., neural growth factor [NGF] and glial cell line-derived growth factor (GDNF), the trafficking of the septohippocampal pathway, and the control of the synthesis process of different neuromodulators (such as acetylcholine [Ach], dopamine [DA], and gamma-aminobutyric [GABA]). Based on these assumptions, we have written this review to summarize the potential role of vitamin D in neurological pathologies. This work could be titanic and the results might have been very fuzzy and even incoherent had we not conjectured to taper our first intentions and devoted our interests towards three mainstreams, demyelinating pathologies, vascular syndromes, and neurodegeneration. As a result of the lack of useful therapeutic options, apart from the disease-modifying strategies, the role of different risk factors should be investigated in neurology, as their correction may lead to the improvement of the cerebral conditions. We have explored the relationships between the gene-environmental influence and long-term vitamin D deficiency, as a risk factor for the development of different types of neurological disorders, along with the role and the rationale of therapeutic trials with vitamin D implementation.
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23
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Simpson S, van der Mei I, Lucas RM, Ponsonby AL, Broadley S, Blizzard L, Taylor B. Sun Exposure across the Life Course Significantly Modulates Early Multiple Sclerosis Clinical Course. Front Neurol 2018; 9:16. [PMID: 29449827 PMCID: PMC5799286 DOI: 10.3389/fneur.2018.00016] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 01/10/2018] [Indexed: 01/08/2023] Open
Abstract
Background Low vitamin D and/or sun exposure have been associated with increased risk of multiple sclerosis (MS) onset. However, comparatively, few studies have prospectively examined associations between these factors and clinical course. Objectives To evaluate the association of sun exposure parameters and vitamin D levels with conversion to MS and relapse risk in a prospectively monitored cohort of 145 participants followed after a first demyelinating event up to 5-year review (AusLong Study). Methods Sun exposure prior to and after onset measured by annual questionnaire; ultraviolet radiation (UVR) "load" estimated by location of residence over the life course and ambient UVR levels. Serum 25-hydroxyvitamin D [25(OH)D] concentrations measured at baseline, 2/3-year, and 5-year review. MS conversion and relapse assessed by neurologist assessment and medical record review. Results Over two-thirds (69%) of those followed to 5-year review (100/145) converted to MS, with a total of 252 relapses. Higher pre-MS onset sun exposure was associated with reduced risk of MS conversion, with internal consistency between measures and dose-response relationships. Analogous associations were also seen with risk of relapse, albeit less strong. No consistent associations were observed between postonset sun exposure and clinical course, however. Notably, those who increased their sun exposure during follow-up had significantly reduced hazards of MS conversion and relapse. Serum 25(OH)D levels and vitamin D supplementation were not associated with conversion to MS or relapse hazard. Conclusion We found that preonset sun exposure was protective against subsequent conversion to MS and relapses. While consistent associations between postonset sun exposure or serum 25(OH)D level and clinical course were not evident, possibly masked by behavior change, those participants who markedly increased their sun exposure demonstrated a reduced MS conversion and relapse hazard, suggesting beneficial effects of sun exposure on clinical course.
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Affiliation(s)
- Steve Simpson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Ingrid van der Mei
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
| | - Anne-Louise Ponsonby
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Royal Melbourne Hospital, School of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Simon Broadley
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | | | - Bruce Taylor
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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24
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Bagur MJ, Murcia MA, Jiménez-Monreal AM, Tur JA, Bibiloni MM, Alonso GL, Martínez-Tomé M. Influence of Diet in Multiple Sclerosis: A Systematic Review. Adv Nutr 2017; 8:463-472. [PMID: 28507011 PMCID: PMC5421121 DOI: 10.3945/an.116.014191] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Nutrition is considered to be a possible factor in the pathogenesis of the neurological disease multiple sclerosis (MS). Nutrition intervention studies suggest that diet may be considered as a complementary treatment to control the progression of the disease; a systematic review of the literature on the influence of diet on MS was therefore conducted. The literature search was conducted by using Medlars Online International Literature (MEDLINE) via PubMed and Scopus. Forty-seven articles met the inclusion criteria. The reviewed articles assessed the relations between macro- and micronutrient intakes and MS incidence. The patients involved used alternative therapies (homeopathy), protocolized diets that included particular foods (herbal products such as grape seed extract, ginseng, blueberries, green tea, etc.), or dietary supplements such as vitamin D, carnitine, melatonin, or coenzyme Q10. Current studies suggest that high serum concentrations of vitamin D, a potent immunomodulator, may decrease the risk of MS and the risk of relapse and new lesions, while improving brain lesions and timed tandem walking. Experimental evidence suggests that serum vitamin D concentration is lower during MS relapses than in remission and is associated with a greater degree of disability [Expanded Disability Status Scale (EDSS) score >3]. The findings suggest that circulating vitamin D concentrations can be considered a biomarker of MS and supplemental vitamin D can be used therapeutically. Other studies point to a negative correlation between serum vitamin B-12 concentrations and EDSS score. Vitamin B-12 has fundamental roles in central nervous system function, especially in the methionine synthase-mediated conversion of homocysteine to methionine, which is essential for DNA and RNA synthesis. Therefore, vitamin B-12 deficiency may lead to an increase in the concentration of homocysteine. Further research is clearly necessary to determine whether treatment with vitamin B-12 supplements delays MS progression.
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Affiliation(s)
- M José Bagur
- Department Science and Technology and Genetics Agroforestal, University of Castilla La-Mancha, Campus Universitario, Albacete, Spain
| | - M Antonia Murcia
- Department of Food Science, Regional Campus of International Excellence “Campus Mare Nostrum,” University of Murcia, Murcia, Spain;,CIBEROBN CB12/03/30038 (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain; and
| | - Antonia M Jiménez-Monreal
- Department of Food Science, Regional Campus of International Excellence “Campus Mare Nostrum,” University of Murcia, Murcia, Spain;,CIBEROBN CB12/03/30038 (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain; and
| | - Josep A Tur
- CIBEROBN CB12/03/30038 (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain; and,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
| | - M Mar Bibiloni
- CIBEROBN CB12/03/30038 (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain; and,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Gonzalo L Alonso
- Department Science and Technology and Genetics Agroforestal, University of Castilla La-Mancha, Campus Universitario, Albacete, Spain
| | - Magdalena Martínez-Tomé
- Department of Food Science, Regional Campus of International Excellence "Campus Mare Nostrum," University of Murcia, Murcia, Spain; .,CIBEROBN CB12/03/30038 (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain; and
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Functional genomics analysis of vitamin D effects on CD4+ T cells in vivo in experimental autoimmune encephalomyelitis . Proc Natl Acad Sci U S A 2017; 114:E1678-E1687. [PMID: 28196884 DOI: 10.1073/pnas.1615783114] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Vitamin D exerts multiple immunomodulatory functions and has been implicated in the etiology and treatment of several autoimmune diseases, including multiple sclerosis (MS). We have previously reported that in juvenile/adolescent rats, vitamin D supplementation protects from experimental autoimmune encephalomyelitis (EAE), a model of MS. Here we demonstrate that this protective effect associates with decreased proliferation of CD4+ T cells and lower frequency of pathogenic T helper (Th) 17 cells. Using transcriptome, methylome, and pathway analyses in CD4+ T cells, we show that vitamin D affects multiple signaling and metabolic pathways critical for T-cell activation and differentiation into Th1 and Th17 subsets in vivo. Namely, Jak/Stat, Erk/Mapk, and Pi3K/Akt/mTor signaling pathway genes were down-regulated upon vitamin D supplementation. The protective effect associated with epigenetic mechanisms, such as (i) changed levels of enzymes involved in establishment and maintenance of epigenetic marks, i.e., DNA methylation and histone modifications; (ii) genome-wide reduction of DNA methylation, and (iii) up-regulation of noncoding RNAs, including microRNAs, with concomitant down-regulation of their protein-coding target RNAs involved in T-cell activation and differentiation. We further demonstrate that treatment of myelin-specific T cells with vitamin D reduces frequency of Th1 and Th17 cells, down-regulates genes in key signaling pathways and epigenetic machinery, and impairs their ability to transfer EAE. Finally, orthologs of nearly 50% of candidate MS risk genes and 40% of signature genes of myelin-reactive T cells in MS changed their expression in vivo in EAE upon supplementation, supporting the hypothesis that vitamin D may modulate risk for developing MS.
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Nielsen NM, Munger KL, Koch-Henriksen N, Hougaard DM, Magyari M, Jørgensen KT, Lundqvist M, Simonsen J, Jess T, Cohen A, Stenager E, Ascherio A. Neonatal vitamin D status and risk of multiple sclerosis: A population-based case-control study. Neurology 2016; 88:44-51. [PMID: 27903815 DOI: 10.1212/wnl.0000000000003454] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 08/24/2016] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE As previous research has suggested that exposure to vitamin D insufficiency in utero may have relevance for the risk of multiple sclerosis (MS), we aimed to examine the direct association between level of neonatal vitamin D and risk of MS. METHODS We carried out a matched case-control study. Dried blood spots samples (DBSS) belonging to 521 patients with MS were identified in the Danish Newborn Screening Biobank. For every patient with MS, 1-2 controls with the same sex and birth date were retrieved from the Biobank (n = 972). Level of 25-hydroxyvitamin D (25[OH]D) in the DBSS was measured using liquid chromatography tandem mass spectroscopy. The association between different levels of 25(OH)D and risk of MS was evaluated by odds ratios (OR) calculated in conditional logistic regression models. RESULTS We observed that lower levels of 25(OH)D in neonates were associated with an increased risk of MS. In the analysis by quintiles, MS risk was highest among individuals in the bottom quintile (<20.7 nmol/L) and lowest among those in the top quintile of 25(OH)D (≥48.9 nmol/L), with an OR for top vs bottom of 0.53 (95% confidence interval [CI] 0.36-0.78). In the analysis treating 25(OH)D as a continuous variable, a 25 nmol/L increase in neonatal 25(OH)D resulted in a 30% reduced risk of MS (OR 0.70, 95% CI 0.57-0.84). CONCLUSION Low concentrations of neonatal vitamin D are associated with an increased risk of MS. In light of the high prevalence of vitamin D insufficiency among pregnant women, our observation may have importance for public health.
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Affiliation(s)
- Nete Munk Nielsen
- From the Department of Epidemiology Research (N.M.N., K.T.J., J.S., T.J.) and the Danish Centre for Neonatal Screening, Department for Congenital Disorders (D.M.H., M.L., A.C.), Statens Serum Institut, Copenhagen, Denmark; Departments of Nutrition (K.L.M., A.A.) and Epidemiology (A.A.), Harvard T.H. Chan School of Public Health, Boston, MA; The Danish Multiple Sclerosis Registry (N.K.-H., M.M., E.S.), Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen (M.M.), and Danish Multiple Sclerosis Research Centre, Department of Neurology, Neuroscience Centre (M.M.), Rigshospitalet, Copenhagen, Denmark; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense, Denmark, and National Institute of Public Health (E.S.), University of Southern Denmark, Copenhagen; Department of Neurology (E.S.), Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Sønderborg, Denmark; Department of Clinical Epidemiology, Clinical Institute (N.K.-H.), University of Aarhus, Aarhus, Denmark; and Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
| | - Kassandra L Munger
- From the Department of Epidemiology Research (N.M.N., K.T.J., J.S., T.J.) and the Danish Centre for Neonatal Screening, Department for Congenital Disorders (D.M.H., M.L., A.C.), Statens Serum Institut, Copenhagen, Denmark; Departments of Nutrition (K.L.M., A.A.) and Epidemiology (A.A.), Harvard T.H. Chan School of Public Health, Boston, MA; The Danish Multiple Sclerosis Registry (N.K.-H., M.M., E.S.), Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen (M.M.), and Danish Multiple Sclerosis Research Centre, Department of Neurology, Neuroscience Centre (M.M.), Rigshospitalet, Copenhagen, Denmark; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense, Denmark, and National Institute of Public Health (E.S.), University of Southern Denmark, Copenhagen; Department of Neurology (E.S.), Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Sønderborg, Denmark; Department of Clinical Epidemiology, Clinical Institute (N.K.-H.), University of Aarhus, Aarhus, Denmark; and Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Nils Koch-Henriksen
- From the Department of Epidemiology Research (N.M.N., K.T.J., J.S., T.J.) and the Danish Centre for Neonatal Screening, Department for Congenital Disorders (D.M.H., M.L., A.C.), Statens Serum Institut, Copenhagen, Denmark; Departments of Nutrition (K.L.M., A.A.) and Epidemiology (A.A.), Harvard T.H. Chan School of Public Health, Boston, MA; The Danish Multiple Sclerosis Registry (N.K.-H., M.M., E.S.), Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen (M.M.), and Danish Multiple Sclerosis Research Centre, Department of Neurology, Neuroscience Centre (M.M.), Rigshospitalet, Copenhagen, Denmark; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense, Denmark, and National Institute of Public Health (E.S.), University of Southern Denmark, Copenhagen; Department of Neurology (E.S.), Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Sønderborg, Denmark; Department of Clinical Epidemiology, Clinical Institute (N.K.-H.), University of Aarhus, Aarhus, Denmark; and Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - David M Hougaard
- From the Department of Epidemiology Research (N.M.N., K.T.J., J.S., T.J.) and the Danish Centre for Neonatal Screening, Department for Congenital Disorders (D.M.H., M.L., A.C.), Statens Serum Institut, Copenhagen, Denmark; Departments of Nutrition (K.L.M., A.A.) and Epidemiology (A.A.), Harvard T.H. Chan School of Public Health, Boston, MA; The Danish Multiple Sclerosis Registry (N.K.-H., M.M., E.S.), Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen (M.M.), and Danish Multiple Sclerosis Research Centre, Department of Neurology, Neuroscience Centre (M.M.), Rigshospitalet, Copenhagen, Denmark; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense, Denmark, and National Institute of Public Health (E.S.), University of Southern Denmark, Copenhagen; Department of Neurology (E.S.), Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Sønderborg, Denmark; Department of Clinical Epidemiology, Clinical Institute (N.K.-H.), University of Aarhus, Aarhus, Denmark; and Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Melinda Magyari
- From the Department of Epidemiology Research (N.M.N., K.T.J., J.S., T.J.) and the Danish Centre for Neonatal Screening, Department for Congenital Disorders (D.M.H., M.L., A.C.), Statens Serum Institut, Copenhagen, Denmark; Departments of Nutrition (K.L.M., A.A.) and Epidemiology (A.A.), Harvard T.H. Chan School of Public Health, Boston, MA; The Danish Multiple Sclerosis Registry (N.K.-H., M.M., E.S.), Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen (M.M.), and Danish Multiple Sclerosis Research Centre, Department of Neurology, Neuroscience Centre (M.M.), Rigshospitalet, Copenhagen, Denmark; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense, Denmark, and National Institute of Public Health (E.S.), University of Southern Denmark, Copenhagen; Department of Neurology (E.S.), Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Sønderborg, Denmark; Department of Clinical Epidemiology, Clinical Institute (N.K.-H.), University of Aarhus, Aarhus, Denmark; and Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Kristian T Jørgensen
- From the Department of Epidemiology Research (N.M.N., K.T.J., J.S., T.J.) and the Danish Centre for Neonatal Screening, Department for Congenital Disorders (D.M.H., M.L., A.C.), Statens Serum Institut, Copenhagen, Denmark; Departments of Nutrition (K.L.M., A.A.) and Epidemiology (A.A.), Harvard T.H. Chan School of Public Health, Boston, MA; The Danish Multiple Sclerosis Registry (N.K.-H., M.M., E.S.), Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen (M.M.), and Danish Multiple Sclerosis Research Centre, Department of Neurology, Neuroscience Centre (M.M.), Rigshospitalet, Copenhagen, Denmark; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense, Denmark, and National Institute of Public Health (E.S.), University of Southern Denmark, Copenhagen; Department of Neurology (E.S.), Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Sønderborg, Denmark; Department of Clinical Epidemiology, Clinical Institute (N.K.-H.), University of Aarhus, Aarhus, Denmark; and Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Marika Lundqvist
- From the Department of Epidemiology Research (N.M.N., K.T.J., J.S., T.J.) and the Danish Centre for Neonatal Screening, Department for Congenital Disorders (D.M.H., M.L., A.C.), Statens Serum Institut, Copenhagen, Denmark; Departments of Nutrition (K.L.M., A.A.) and Epidemiology (A.A.), Harvard T.H. Chan School of Public Health, Boston, MA; The Danish Multiple Sclerosis Registry (N.K.-H., M.M., E.S.), Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen (M.M.), and Danish Multiple Sclerosis Research Centre, Department of Neurology, Neuroscience Centre (M.M.), Rigshospitalet, Copenhagen, Denmark; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense, Denmark, and National Institute of Public Health (E.S.), University of Southern Denmark, Copenhagen; Department of Neurology (E.S.), Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Sønderborg, Denmark; Department of Clinical Epidemiology, Clinical Institute (N.K.-H.), University of Aarhus, Aarhus, Denmark; and Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jacob Simonsen
- From the Department of Epidemiology Research (N.M.N., K.T.J., J.S., T.J.) and the Danish Centre for Neonatal Screening, Department for Congenital Disorders (D.M.H., M.L., A.C.), Statens Serum Institut, Copenhagen, Denmark; Departments of Nutrition (K.L.M., A.A.) and Epidemiology (A.A.), Harvard T.H. Chan School of Public Health, Boston, MA; The Danish Multiple Sclerosis Registry (N.K.-H., M.M., E.S.), Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen (M.M.), and Danish Multiple Sclerosis Research Centre, Department of Neurology, Neuroscience Centre (M.M.), Rigshospitalet, Copenhagen, Denmark; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense, Denmark, and National Institute of Public Health (E.S.), University of Southern Denmark, Copenhagen; Department of Neurology (E.S.), Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Sønderborg, Denmark; Department of Clinical Epidemiology, Clinical Institute (N.K.-H.), University of Aarhus, Aarhus, Denmark; and Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Tine Jess
- From the Department of Epidemiology Research (N.M.N., K.T.J., J.S., T.J.) and the Danish Centre for Neonatal Screening, Department for Congenital Disorders (D.M.H., M.L., A.C.), Statens Serum Institut, Copenhagen, Denmark; Departments of Nutrition (K.L.M., A.A.) and Epidemiology (A.A.), Harvard T.H. Chan School of Public Health, Boston, MA; The Danish Multiple Sclerosis Registry (N.K.-H., M.M., E.S.), Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen (M.M.), and Danish Multiple Sclerosis Research Centre, Department of Neurology, Neuroscience Centre (M.M.), Rigshospitalet, Copenhagen, Denmark; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense, Denmark, and National Institute of Public Health (E.S.), University of Southern Denmark, Copenhagen; Department of Neurology (E.S.), Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Sønderborg, Denmark; Department of Clinical Epidemiology, Clinical Institute (N.K.-H.), University of Aarhus, Aarhus, Denmark; and Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Arieh Cohen
- From the Department of Epidemiology Research (N.M.N., K.T.J., J.S., T.J.) and the Danish Centre for Neonatal Screening, Department for Congenital Disorders (D.M.H., M.L., A.C.), Statens Serum Institut, Copenhagen, Denmark; Departments of Nutrition (K.L.M., A.A.) and Epidemiology (A.A.), Harvard T.H. Chan School of Public Health, Boston, MA; The Danish Multiple Sclerosis Registry (N.K.-H., M.M., E.S.), Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen (M.M.), and Danish Multiple Sclerosis Research Centre, Department of Neurology, Neuroscience Centre (M.M.), Rigshospitalet, Copenhagen, Denmark; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense, Denmark, and National Institute of Public Health (E.S.), University of Southern Denmark, Copenhagen; Department of Neurology (E.S.), Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Sønderborg, Denmark; Department of Clinical Epidemiology, Clinical Institute (N.K.-H.), University of Aarhus, Aarhus, Denmark; and Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Egon Stenager
- From the Department of Epidemiology Research (N.M.N., K.T.J., J.S., T.J.) and the Danish Centre for Neonatal Screening, Department for Congenital Disorders (D.M.H., M.L., A.C.), Statens Serum Institut, Copenhagen, Denmark; Departments of Nutrition (K.L.M., A.A.) and Epidemiology (A.A.), Harvard T.H. Chan School of Public Health, Boston, MA; The Danish Multiple Sclerosis Registry (N.K.-H., M.M., E.S.), Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen (M.M.), and Danish Multiple Sclerosis Research Centre, Department of Neurology, Neuroscience Centre (M.M.), Rigshospitalet, Copenhagen, Denmark; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense, Denmark, and National Institute of Public Health (E.S.), University of Southern Denmark, Copenhagen; Department of Neurology (E.S.), Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Sønderborg, Denmark; Department of Clinical Epidemiology, Clinical Institute (N.K.-H.), University of Aarhus, Aarhus, Denmark; and Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Alberto Ascherio
- From the Department of Epidemiology Research (N.M.N., K.T.J., J.S., T.J.) and the Danish Centre for Neonatal Screening, Department for Congenital Disorders (D.M.H., M.L., A.C.), Statens Serum Institut, Copenhagen, Denmark; Departments of Nutrition (K.L.M., A.A.) and Epidemiology (A.A.), Harvard T.H. Chan School of Public Health, Boston, MA; The Danish Multiple Sclerosis Registry (N.K.-H., M.M., E.S.), Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen (M.M.), and Danish Multiple Sclerosis Research Centre, Department of Neurology, Neuroscience Centre (M.M.), Rigshospitalet, Copenhagen, Denmark; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense, Denmark, and National Institute of Public Health (E.S.), University of Southern Denmark, Copenhagen; Department of Neurology (E.S.), Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Sønderborg, Denmark; Department of Clinical Epidemiology, Clinical Institute (N.K.-H.), University of Aarhus, Aarhus, Denmark; and Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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Bove R, White CC, Fitzgerald KC, Chitnis T, Chibnik L, Ascherio A, Munger KL. Hormone therapy use and physical quality of life in postmenopausal women with multiple sclerosis. Neurology 2016; 87:1457-1463. [PMID: 27605175 DOI: 10.1212/wnl.0000000000003176] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/12/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the association between hormone therapy (HT) and physical quality of life (QOL) in postmenopausal women with multiple sclerosis (MS). METHODS We included female participants from the prospective Nurses' Health Study, with a diagnosis of definite or probable MS, who had completed a physical functioning assessment (PF10; subscale of the 36-Item Short-Form Health Survey QOL survey) at a time point between 3 and 10 years after their final menstrual period (early postmenopause). We assessed the association between HT use at this time point (never vs at least 12 months of systemic estrogen with/without progestin) and both PF10 and the 36-Item Short-Form Health Survey Physical Component Scale. We used a linear regression model adjusting for age, MS duration, menopause type and duration, and further for additional covariates (only ancestry was significant). RESULTS Among 95 participants meeting all inclusion criteria at their first postmenopausal assessment, 61 reported HT use and 34 reported none. HT users differed from non-HT users in MS duration (p = 0.02) and menopause type (p = 0.01) but no other clinical or demographic characteristics. HT users had average PF10 scores that were 23 points higher than non-HT users (adjusted p = 0.004) and average Physical Component Scale scores that were 9.1 points higher in the 59 women with these available (adjusted p = 0.02). Longer duration of HT use was also associated with higher PF10 scores (p = 0.02, adjusted p = 0.06). CONCLUSIONS Systemic HT use was associated with better physical QOL in postmenopausal women with MS in this observational study. Further studies are necessary to investigate causality.
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Affiliation(s)
- Riley Bove
- From the UCSF MS Center (R.B.), Department of Neurology, UCSF, Sandler Neurosciences Center, San Francisco, CA; Ann Romney Center for Neurologic Diseases (C.C.W., T.C., L.C.), Harvard Medical School, Boston, MA; Johns Hopkins Medical Institute (K.C.F.), Department of Neurology and Neuroimmunology, Baltimore, MD; Partners Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Brookline; Harvard Medical School (T.C., L.C.), Boston; Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston; and Departments of Nutrition (A.A., K.L.M.) and Epidemiology (L.C., A.A.), Harvard T.H. Chan School of Public Health, Boston, MA.
| | - Charles C White
- From the UCSF MS Center (R.B.), Department of Neurology, UCSF, Sandler Neurosciences Center, San Francisco, CA; Ann Romney Center for Neurologic Diseases (C.C.W., T.C., L.C.), Harvard Medical School, Boston, MA; Johns Hopkins Medical Institute (K.C.F.), Department of Neurology and Neuroimmunology, Baltimore, MD; Partners Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Brookline; Harvard Medical School (T.C., L.C.), Boston; Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston; and Departments of Nutrition (A.A., K.L.M.) and Epidemiology (L.C., A.A.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Kathryn C Fitzgerald
- From the UCSF MS Center (R.B.), Department of Neurology, UCSF, Sandler Neurosciences Center, San Francisco, CA; Ann Romney Center for Neurologic Diseases (C.C.W., T.C., L.C.), Harvard Medical School, Boston, MA; Johns Hopkins Medical Institute (K.C.F.), Department of Neurology and Neuroimmunology, Baltimore, MD; Partners Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Brookline; Harvard Medical School (T.C., L.C.), Boston; Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston; and Departments of Nutrition (A.A., K.L.M.) and Epidemiology (L.C., A.A.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Tanuja Chitnis
- From the UCSF MS Center (R.B.), Department of Neurology, UCSF, Sandler Neurosciences Center, San Francisco, CA; Ann Romney Center for Neurologic Diseases (C.C.W., T.C., L.C.), Harvard Medical School, Boston, MA; Johns Hopkins Medical Institute (K.C.F.), Department of Neurology and Neuroimmunology, Baltimore, MD; Partners Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Brookline; Harvard Medical School (T.C., L.C.), Boston; Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston; and Departments of Nutrition (A.A., K.L.M.) and Epidemiology (L.C., A.A.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lori Chibnik
- From the UCSF MS Center (R.B.), Department of Neurology, UCSF, Sandler Neurosciences Center, San Francisco, CA; Ann Romney Center for Neurologic Diseases (C.C.W., T.C., L.C.), Harvard Medical School, Boston, MA; Johns Hopkins Medical Institute (K.C.F.), Department of Neurology and Neuroimmunology, Baltimore, MD; Partners Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Brookline; Harvard Medical School (T.C., L.C.), Boston; Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston; and Departments of Nutrition (A.A., K.L.M.) and Epidemiology (L.C., A.A.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Alberto Ascherio
- From the UCSF MS Center (R.B.), Department of Neurology, UCSF, Sandler Neurosciences Center, San Francisco, CA; Ann Romney Center for Neurologic Diseases (C.C.W., T.C., L.C.), Harvard Medical School, Boston, MA; Johns Hopkins Medical Institute (K.C.F.), Department of Neurology and Neuroimmunology, Baltimore, MD; Partners Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Brookline; Harvard Medical School (T.C., L.C.), Boston; Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston; and Departments of Nutrition (A.A., K.L.M.) and Epidemiology (L.C., A.A.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Kassandra L Munger
- From the UCSF MS Center (R.B.), Department of Neurology, UCSF, Sandler Neurosciences Center, San Francisco, CA; Ann Romney Center for Neurologic Diseases (C.C.W., T.C., L.C.), Harvard Medical School, Boston, MA; Johns Hopkins Medical Institute (K.C.F.), Department of Neurology and Neuroimmunology, Baltimore, MD; Partners Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Brookline; Harvard Medical School (T.C., L.C.), Boston; Channing Division of Network Medicine (A.A.), Brigham and Women's Hospital and Harvard Medical School, Boston; and Departments of Nutrition (A.A., K.L.M.) and Epidemiology (L.C., A.A.), Harvard T.H. Chan School of Public Health, Boston, MA
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Nielsen NM, Stenager E. Multiple sclerosis: potential risk factors in childhood and adolescence. Neurodegener Dis Manag 2016; 6:73-6. [PMID: 27034134 DOI: 10.2217/nmt.16.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Nete Munk Nielsen
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - Egon Stenager
- The Danish Multiple Sclerosis Registry, Rigshospitalet, Copenhagen, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Department of Neurology, Sønderborg, Denmark.,National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Abstract
Multiple sclerosis (MS) is a common neurological disease, and its etiology remains unknown. In recent years, increasing attention has been paid to the possible association between MS and vitamin D deficiency. Here, we review the current literature between MS and vitamin D, showing clear evidence that vitamin D deficiency is a risk factor for MS despite the lack of direct evidence for the effects of vitamin D in MS progression.
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Affiliation(s)
- Fatimah M. Alharbi
- From the Department of Neurology, College of Medicine, Qassim University, Buraidah, Kingdom of Saudi Arabia,Address correspondence and reprint request to: Dr. Fatimah M. Alharbi, Department of Neurology, College of Medicine, Qassim University, Buraidah, Kingdom of Saudi Arabia. E-mail:
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Casper TC, Rose JW, Roalstad S, Waubant E, Aaen G, Belman A, Chitnis T, Gorman M, Krupp L, Lotze TE, Ness J, Patterson M, Rodriguez M, Weinstock-Guttman B, Browning B, Graves J, Tillema JM, Benson L, Harris Y. The US Network of Pediatric Multiple Sclerosis Centers: Development, Progress, and Next Steps. J Child Neurol 2015; 30:1381-7. [PMID: 25270659 PMCID: PMC4379142 DOI: 10.1177/0883073814550656] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 08/19/2014] [Indexed: 11/16/2022]
Abstract
Multiple sclerosis and other demyelinating diseases in the pediatric population have received an increasing level of attention by clinicians and researchers. The low incidence of these diseases in children creates a need for the involvement of multiple clinical centers in research efforts. The Network of Pediatric Multiple Sclerosis Centers was created initially in 2006 to improve the diagnosis and care of children with demyelinating diseases. In 2010, the Network shifted its focus to multicenter research while continuing to advance the care of patients. The Network has obtained support from the National Multiple Sclerosis Society, the Guthy-Jackson Charitable Foundation, and the National Institutes of Health. The Network will continue to serve as a platform for conducting impactful research in pediatric demyelinating diseases of the central nervous system. This article provides a description of the history and development, organization, mission, research priorities, current studies, and future plans of the Network.
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Affiliation(s)
- T Charles Casper
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - John W Rose
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Shelly Roalstad
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Emmanuelle Waubant
- Department of Neurology, University of California, San Francisco, CA, USA Department of Pediatrics, Benioff Children's Hospitals, San Francisco, CA, USA
| | - Gregory Aaen
- Pediatric MS Center at Loma Linda University Children's Hospital, Loma Linda, CA, USA
| | - Anita Belman
- Lourie Center for Pediatric MS, Stony Brook Children's Hospital, Stony Brook, NY, USA
| | - Tanuja Chitnis
- Partners MS Center, Harvard Medical School, Boston, MA, USA
| | - Mark Gorman
- Pediatric Multiple Sclerosis and Related Diseases Program, Boston Children's Hospital, Boston, MA, USA
| | - Lauren Krupp
- Lourie Center for Pediatric MS, Stony Brook Children's Hospital, Stony Brook, NY, USA
| | - Timothy E Lotze
- Blue Bird Circle Multiple Sclerosis Center, Texas Children's Hospital, Houston, TX, USA
| | - Jayne Ness
- UAB Center for Pediatric Onset Demyelinating Disease, Children's Hospital of Alabama, Birmingham, AL, USA
| | | | | | - Bianca Weinstock-Guttman
- Pediatric Multiple Sclerosis Center, Jacobs Neurological Institute, SUNY Buffalo, Buffalo, NY, USA
| | - Brittan Browning
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Jennifer Graves
- Department of Neurology, University of California, San Francisco, CA, USA
| | | | - Leslie Benson
- Pediatric Multiple Sclerosis and Related Diseases Program, Boston Children's Hospital, Boston, MA, USA
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31
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Incidence of Multiple Sclerosis and Related Disorders in Asian Populations of British Columbia. Can J Neurol Sci 2015; 42:235-41. [PMID: 26074012 DOI: 10.1017/cjn.2015.36] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Global variation in the incidence of multiple sclerosis (MS) is generally ascribed to differences in genetic and environmental risk factors. Here we investigate temporal trends in the incidence of MS and related disorders in British Columbia, Canada, from 1986 to 2010, focusing particularly on the Asian ethnic subpopulation. METHODS A longitudinal database was screened to identify newly diagnosed cases of MS and related disorders, including neuromyelitis optica and clinically isolated syndromes. Age-standardized, sex-specific mean annual incidence was calculated for the Asian and non-Asian population of British Columbia for 5-year intervals from 1986 to 2010. Temporal changes and cohort differences in incidence rates and demographic characteristics were evaluated. RESULTS During this period, the incidence of MS and related disorders in the non-Asian population remained relatively unchanged, from 10.41 (95% confidence interval [CI]: 9.87-10.97) to 9.91 (95% CI: 9.46-10.39) per 100,000 (p=0.167). In contrast, incidence in the Asian population doubled during the same period. This increase was driven by a precipitous rise in the incidence of MS in females from 0.71 (95% CI: 0.01-1.50) to 2.08 (95% CI: 1.43-2.91) per 100,000 (p=0.004), including both Canadian-born and immigrant Asians. The incidence of neuromyelitis optica did not change significantly during this period. CONCLUSIONS The incidence of MS may be increasing among females in the Asian ethnic population of British Columbia.
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Magalhaes S, Pugliatti M, Casetta I, Drulovic J, Granieri E, Holmøy T, Kampman MT, Landtblom AM, Lauer K, Myhr KM, Parpinel M, Pekmezovic T, Riise T, Wolfson D, Zhu B, Wolfson C. The EnvIMS Study: Design and Methodology of an International Case-Control Study of Environmental Risk Factors in Multiple Sclerosis. Neuroepidemiology 2015; 44:173-81. [DOI: 10.1159/000381779] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 03/13/2015] [Indexed: 11/19/2022] Open
Abstract
Background: Multiple sclerosis (MS) is a chronic disease of the central nervous system, often resulting in significant neurological disability. The causes of MS are not known; however, the incidence of MS is increasing, thereby suggesting that changes in lifestyle and/or environmental factors may be responsible. On this background, the Environmental Risk Factors in MS Study or EnvIMS study was designed to further explore the etiology of MS. The design and methodology are described, providing details to enable investigators to (i) use our experiences to design their own studies; (ii) take advantage of, and build on the methodological work completed for, the EnvIMS study; (iii) become aware of this data source that is available for use by the research community. Methods: EnvIMS is a multinational case-control study, enrolling 2,800 cases with MS and 5,012 population-based controls in Canada, Italy, Norway, Serbia and Sweden. The study was designed to investigate the most commonly implicated risk factors for MS etiology using a self-report questionnaire. Results/Conclusions: The use of a common methodology to study MS etiology across several countries enhances the comparability of results in different geographic regions and research settings, reduces the resources required for study design and enhances the opportunity for data harmonization.
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Cortese M, Riise T, Bjørnevik K, Holmøy T, Kampman MT, Magalhaes S, Pugliatti M, Wolfson C, Myhr KM. Timing of use of cod liver oil, a vitamin D source, and multiple sclerosis risk: The EnvIMS study. Mult Scler 2015; 21:1856-64. [PMID: 25948625 PMCID: PMC4657387 DOI: 10.1177/1352458515578770] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 02/28/2015] [Indexed: 11/24/2022]
Abstract
Background: Low vitamin D levels have been associated with an increased risk of multiple sclerosis (MS), although it remains unknown whether this relationship varies by age. Objective: The objective of this paper is to investigate the association between vitamin D3 supplementation through cod liver oil at different postnatal ages and MS risk. Methods: In the Norwegian component of the multinational case-control study Environmental Factors In Multiple Sclerosis (EnvIMS), a total of 953 MS patients with maximum disease duration of 10 years and 1717 controls reported their cod liver oil use from childhood to adulthood. Results: Self-reported supplement use at ages 13–18 was associated with a reduced risk of MS (OR 0.67, 95% CI 0.52–0.86), whereas supplementation during childhood was not found to alter MS risk (OR 1.01, 95% CI 0.81–1.26), each compared to non-use during the respective period. An inverse association was found between MS risk and the dose of cod liver oil during adolescence, suggesting a dose-response relationship (p trend = 0.001) with the strongest effect for an estimated vitamin D3 intake of 600–800 IU/d (OR 0.46, 95% CI 0.31–0.70). Conclusions: These findings not only support the hypothesis relating to low vitamin D as a risk factor for MS, but further point to adolescence as an important susceptibility period for adult-onset MS.
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Affiliation(s)
- Marianna Cortese
- The KG Jebsen Centre for MS-Research, Department of Clinical Medicine, University of Bergen, Norway/Department of Global Public Health and Primary Care, University of Bergen, Norway/Department of Nutrition, Harvard T.H. Chan School of Public Health, USA
| | - Trond Riise
- Department of Global Public Health and Primary Care, University of Bergen, Norway/The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Norway
| | - Kjetil Bjørnevik
- Department of Global Public Health and Primary Care, University of Bergen, Norway/Department of Nutrition, Harvard T.H. Chan School of Public Health, USA/The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Norway
| | - Trygve Holmøy
- Institute of Clinical Medicine, University of Oslo, Norway/Department of Neurology, Akershus University Hospital, Norway
| | | | - Sandra Magalhaes
- Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Canada
| | - Maura Pugliatti
- Department of Global Public Health and Primary Care, University of Bergen, Norway/Department of Clinical and Experimental Medicine, University of Sassari, Italy/Division of Medicine, McGill University, Canada
| | - Christina Wolfson
- Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Canada/Research Institute of the McGill University Health Centre, Canada
| | - Kjell-Morten Myhr
- The KG Jebsen Centre for MS-Research, Department of Clinical Medicine, University of Bergen, Norway/The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Norway
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34
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Abstract
Beyond its critical function in calcium homeostasis, vitamin D has recently been found to play an important role in the modulation of the immune/inflammation system via regulating the production of inflammatory cytokines and inhibiting the proliferation of proinflammatory cells, both of which are crucial for the pathogenesis of inflammatory diseases. Several studies have associated lower vitamin D status with increased risk and unfavorable outcome of acute infections. Vitamin D supplementation bolsters clinical responses to acute infection. Moreover, chronic inflammatory diseases, such as atherosclerosis-related cardiovascular disease, asthma, inflammatory bowel disease, chronic kidney disease, nonalcoholic fatty liver disease, and others, tend to have lower vitamin D status, which may play a pleiotropic role in the pathogenesis of the diseases. In this article, we review recent epidemiological and interventional studies of vitamin D in various inflammatory diseases. The potential mechanisms of vitamin D in regulating immune/inflammatory responses in inflammatory diseases are also discussed.
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Affiliation(s)
- Kai Yin
- Center for Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, USA
| | - Devendra K Agrawal
- Center for Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, USA
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35
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DeLuca GC, Kimball SM, Kolasinski J, Ramagopalan SV, Ebers GC. Review: the role of vitamin D in nervous system health and disease. Neuropathol Appl Neurobiol 2014; 39:458-84. [PMID: 23336971 DOI: 10.1111/nan.12020] [Citation(s) in RCA: 214] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 01/16/2013] [Indexed: 12/13/2022]
Abstract
Vitamin D and its metabolites have pleomorphic roles in both nervous system health and disease. Animal models have been paramount in contributing to our knowledge and understanding of the consequences of vitamin D deficiency on brain development and its implications for adult psychiatric and neurological diseases. The conflation of in vitro, ex vivo, and animal model data provide compelling evidence that vitamin D has a crucial role in proliferation, differentiation, neurotrophism, neuroprotection, neurotransmission, and neuroplasticity. Vitamin D exerts its biological function not only by influencing cellular processes directly, but also by influencing gene expression through vitamin D response elements. This review highlights the epidemiological, neuropathological, experimental and molecular genetic evidence implicating vitamin D as a candidate in influencing susceptibility to a number of psychiatric and neurological diseases. The strength of evidence varies for schizophrenia, autism, Parkinson's disease, amyotrophic lateral sclerosis, Alzheimer's disease, and is especially strong for multiple sclerosis.
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Affiliation(s)
- G C DeLuca
- Nuffield Department of Clinical Neurosciences (Clinical Neurology), University of Oxford, Oxford, UK.
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36
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Lee EB, Mattson MP. The neuropathology of obesity: insights from human disease. Acta Neuropathol 2014; 127:3-28. [PMID: 24096619 DOI: 10.1007/s00401-013-1190-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 09/27/2013] [Accepted: 09/28/2013] [Indexed: 02/06/2023]
Abstract
Obesity, a pathologic state defined by excess adipose tissue, is a significant public health problem as it affects a large proportion of individuals and is linked with increased risk for numerous chronic diseases. Obesity is the result of fundamental changes associated with modern society including overnutrition and sedentary lifestyles. Proper energy homeostasis is dependent on normal brain function as the master metabolic regulator, which integrates peripheral signals, modulates autonomic outflow and controls feeding behavior. Therefore, many human brain diseases are associated with obesity. This review explores the neuropathology of obesity by examining brain diseases which either cause or are influenced by obesity. First, several genetic and acquired brain diseases are discussed as a means to understand the central regulation of peripheral metabolism. These diseases range from monogenetic causes of obesity (leptin deficiency, MC4R deficiency, Bardet-Biedl syndrome and others) to complex neurodevelopmental disorders (Prader-Willi syndrome and Sim1 deficiency) and neurodegenerative conditions (frontotemporal dementia and Gourmand's syndrome) and serve to highlight the central regulatory mechanisms which have evolved to maintain energy homeostasis. Next, to examine the effect of obesity on the brain, chronic neuropathologic conditions (epilepsy, multiple sclerosis and Alzheimer's disease) are discussed as examples of obesity leading to maladaptive processes which exacerbate chronic disease. Thus, obesity is associated with multiple pathways including abnormal metabolism, altered hormonal signaling and increased inflammation which act in concert to promote downstream neuropathology. Finally, the effect of anti-obesity interventions is discussed in terms of brain structure and function. Together, understanding human diseases and anti-obesity interventions leads to insights into the bidirectional interaction between peripheral metabolism and central brain function, highlighting the need for continued clinicopathologic and mechanistic studies of the neuropathology of obesity.
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37
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Chitnis T. Role of puberty in multiple sclerosis risk and course. Clin Immunol 2013; 149:192-200. [DOI: 10.1016/j.clim.2013.03.014] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 03/22/2013] [Accepted: 03/24/2013] [Indexed: 01/06/2023]
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38
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Efficacy of vitamin D in treating multiple sclerosis-like neuroinflammation depends on developmental stage. Exp Neurol 2013; 249:39-48. [DOI: 10.1016/j.expneurol.2013.08.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 07/02/2013] [Accepted: 08/06/2013] [Indexed: 11/23/2022]
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39
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Bäärnhielm M, Olsson T, Alfredsson L. Fatty fish intake is associated with decreased occurrence of multiple sclerosis. Mult Scler 2013; 20:726-32. [PMID: 24158977 DOI: 10.1177/1352458513509508] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND High vitamin D levels have been associated with a decreased risk of developing multiple sclerosis (MS). The most important source of dietary vitamin D is fatty fish. OBJECTIVE The objective of this paper is to investigate the association between fish consumption and the risk of MS, including the interaction between fish intake and ultraviolet radiation (UVR) exposure habits. METHODS This study is based on the project Epidemiological Investigation of MS (EIMS), which is a Swedish population-based case-control study. The analysis included 1879 incident cases of MS and 4135 controls. Subjects who reported high fatty fish intake were compared regarding occurrence of MS with those who reported low intake by calculating odds ratio (OR) with 95% confidence interval (CI). RESULTS Frequent fatty fish intake was associated with decreased occurrence of MS (adjusted OR 0.82 (95% CI 0.68-0.98). There was no significant association between intake of lean fish and MS. CONCLUSION Fatty fish intake might decrease the risk for MS. A hypothetical explanation is that intake of fatty fish may compensate for vitamin D deficiency that is associated with increased MS risk.
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Affiliation(s)
- Maria Bäärnhielm
- Institute of Environmental Medicine, Karolinska Institutet, Sweden
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40
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Hewer S, Lucas R, van der Mei I, Taylor BV. Vitamin D and multiple sclerosis. J Clin Neurosci 2013; 20:634-41. [PMID: 23540892 DOI: 10.1016/j.jocn.2012.10.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 10/31/2012] [Accepted: 10/31/2012] [Indexed: 12/19/2022]
Abstract
The role of vitamin D supplementation in preventing multiple sclerosis (MS) and/or treating MS progression is an area of significant research interest. We detail the current status of the ongoing research in this field, and note the lack of class 1 evidence from well-conducted, large, double-blind, placebo-controlled studies of vitamin D supplementation in the prevention and/or treatment of MS. We have been able to provide some guidelines for practitioners based on the substantial burden of supportive evidence for the use of vitamin D in MS as summarised here. These guidelines may provide some support to those clinicians who treat people with MS and their families.
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Affiliation(s)
- Sarah Hewer
- Royal Hobart Hospital, Department of Neurology, Hobart, Tasmania, Australia
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41
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Pierrot-Deseilligny C, Souberbielle JC. Contribution of vitamin D insufficiency to the pathogenesis of multiple sclerosis. Ther Adv Neurol Disord 2013; 6:81-116. [PMID: 23483715 PMCID: PMC3582312 DOI: 10.1177/1756285612473513] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The contribution of vitamin D insufficiency to the pathogenesis of multiple sclerosis (MS) is reviewed. Among the multiple recently discovered actions of vitamin D, an immunomodulatory role has been documented in experimental autoimmune encephalomyelitis and in humans. This action in the peripheral immune system is currently the main known mechanism through which vitamin D might influence MS, but other types of actions could be involved within the central nervous system. Furthermore, vitamin D insufficiency is widespread in temperate countries and in patients with MS at the earliest stages of the disease, suggesting that the deleterious effects related to vitamin D insufficiency may be exerted in these patients. In fact, many genetic and environmental risk factors appear to interact and contribute to MS. In genetics, several human leukocyte antigen (HLA) alleles (more particularly HLA-DRB1*1501) could favour the disease whereas some others could be protective. Some of the genes involved in vitamin D metabolism (e.g. CYP27B1) also play a significant role. Furthermore, three environmental risk factors have been identified: past Epstein-Barr virus infection, vitamin D insufficiency and cigarette smoking. Interactions between genetic and environmental risk or protective factors may occur during the mother's pregnancy and could continue during childhood and adolescence and until the disease is triggered in adulthood, therefore possibly modulating the MS risk throughout the first decades of life. Furthermore, some clinical findings already strongly suggest that vitamin D status influences the relapse rate and radiological lesions in patients with MS, although the results of adequately powered randomized clinical trials using vitamin D supplementation have not yet been reported. While awaiting these incontrovertible results, which might be long in coming, patients with MS who are currently in vitamin D insufficiency should be supplemented, at least for their general health status, using moderate doses of the vitamin.
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Affiliation(s)
- Charles Pierrot-Deseilligny
- Service de Neurologie 1, Hôpital de la Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie (Paris VI), Paris, France
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42
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Carlson NG, Rose JW. Vitamin D as a clinical biomarker in multiple sclerosis. ACTA ACUST UNITED AC 2013; 7:231-42. [DOI: 10.1517/17530059.2013.772978] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Hiraki LT, Munger KL, Costenbader KH, Karlson EW. Dietary intake of vitamin D during adolescence and risk of adult-onset systemic lupus erythematosus and rheumatoid arthritis. Arthritis Care Res (Hoboken) 2013; 64:1829-36. [PMID: 22744978 DOI: 10.1002/acr.21776] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 06/15/2012] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Vitamin D has immunomodulatory properties with potential etiologic implications for autoimmune diseases. The relevant exposure time during which vitamin D may influence disease risk is unknown. Our objective was to examine the relationship between reported vitamin D intake during adolescence and adult-onset rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) incidence in prospective cohort studies of women, the Nurses' Health Study (NHS) and the Nurses' Health Study II (NHSII). METHODS Food frequency questionnaires concerning high school diet completed by 73,629 NHS (1986) and 45,544 NHSII (1998) participants were used to calculate nutrient intakes during adolescence. Incident RA and SLE cases prior to 2006 (NHS) and 2007 (NHSII) were confirmed by medical record review. Cox proportional hazards models calculated relative risks and 95% confidence intervals of incident RA and SLE according to quintile cutoffs of vitamin D intake. Age- and calorie-adjusted and multivariable-adjusted (including sun exposure factors) analyses were completed. Random-effects models were used to meta-analyze estimates of association from the 2 cohorts. RESULTS Incident RA was confirmed in 652 NHS and 148 NHSII participants and SLE was confirmed in 122 NHS and 54 NHSII participants over a mean followup time of 351 months (NHS) and 209 months (NHSII). Age- and calorie-adjusted and multivariable-adjusted models did not show significant associations between adolescent vitamin D intake and risk of adult-onset RA or SLE. CONCLUSION We did not find associations between adolescent dietary vitamin D intake and adult RA or SLE risk among NHS and NHSII women, suggesting that other time periods during the life course should be studied.
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Affiliation(s)
- Linda T Hiraki
- Harvard School of Public Health and Brigham and Women's Hospital, Boston, MA 02115, USA.
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44
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Faridar A, Eskandari G, Sahraian MA, Minagar A, Azimi A. Vitamin D and multiple sclerosis: a critical review and recommendations on treatment. Acta Neurol Belg 2012; 112:327-33. [PMID: 22767049 DOI: 10.1007/s13760-012-0108-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 06/19/2012] [Indexed: 11/26/2022]
Abstract
Multiple sclerosis (MS) is an immune-mediated and degenerative disease of nervous system, which affects mostly young adults. Vitamin D deficiency is a well-known environmental risk factor for MS and is considerable in terms of immediate clinical implications. In addition to its classical action on regulation of bone homeostasis, vitamin D may have a potent impact on cytokine profiles and neuro-inflammation. Given the immunomodulatory effects of vitamin D and its high rate of deficiency in MS patients, prescribing vitamin D is a remarkable issue in MS. The results from several experimental and clinical studies indicate that vitamin D supplementation may ameliorate the inflammation during the relapse phase and attenuate disease progression. We present the experimental and clinical studies, which assessed the effects of vitamin D on the pathophysiology, prevalence and management of MS. The authors also discuss current recommendations on prescription of this vitamin to MS patients.
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Affiliation(s)
- Alireza Faridar
- Department of Neurology, University of California, San Francisco, USA
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45
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Galimberti D, Scarpini E. Progress in multiple sclerosis research in the last year. J Neurol 2012; 259:1497-501. [DOI: 10.1007/s00415-012-6578-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 06/01/2012] [Accepted: 06/02/2012] [Indexed: 11/28/2022]
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46
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Abstract
PURPOSE OF REVIEW This review provides a brief update of new research findings on the role of vitamin D in multiple sclerosis (MS). RECENT FINDINGS Evidence continues to accumulate supporting a protective role for vitamin D in MS risk and progression. Notable recent findings are that high 25-hydroxyvitamin D [25(OH)D] at the time of a first demyelinating event predicts a lower MS risk and a decreased risk of MS among offspring whose mothers had high predicted 25(OH)D levels. While a small vitamin D intervention study did not find an association between vitamin D and MS progression, this study had little statistical power, and larger trials will be needed to assess the therapeutic potential of vitamin D. Recent immunological studies also show modulation of the immune system by vitamin D that may be favorable for preventing or slowing the progression of MS. The demonstration that rare variants in CYP27B1, which encodes the enzyme that converts vitamin D to its active form, are strongly associated with MS risk supports a causal role of vitamin D deficiency as a risk factor for MS. SUMMARY Research on the nature of the association between vitamin D and MS risk and progression continues to progress; however, additional research on the timing and dose-response relationship will be crucial for designing future prevention and treatment trials.
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Affiliation(s)
- Kelly C Simon
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
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47
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Grant WB, Mascitelli L. Evidence that the north–south gradient of multiple sclerosis may not have disappeared. J Neurol Sci 2012; 315:178-9. [DOI: 10.1016/j.jns.2012.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 01/04/2012] [Indexed: 01/08/2023]
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48
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Current world literature. Curr Opin Pediatr 2012; 24:134-44. [PMID: 22245849 DOI: 10.1097/mop.0b013e328350498a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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49
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Fernandes de Abreu DA, Landel V, Féron F. Seasonal, gestational and postnatal influences on multiple sclerosis: The beneficial role of a vitamin D supplementation during early life. J Neurol Sci 2011; 311:64-8. [DOI: 10.1016/j.jns.2011.08.044] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 08/23/2011] [Accepted: 08/29/2011] [Indexed: 11/15/2022]
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50
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Simon KC, Munger KL, Ascherio A. XVI European Charcot Foundation lecture: nutrition and environment: can MS be prevented? J Neurol Sci 2011; 311:1-8. [PMID: 21975017 DOI: 10.1016/j.jns.2011.09.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 09/08/2011] [Accepted: 09/08/2011] [Indexed: 01/09/2023]
Abstract
Multiple sclerosis (MS) is a relatively common debilitating neurologic disease that affects people in early adulthood. While the characteristic pathology of MS has been well described, the etiology of the disease is not well understood, despite decades of research and the identification of strong genetic and environmental candidates for susceptibility. A question central to all diseases, but posed specifically for MS at the XVI European Charcot Foundation Lecture, was 'Can MS be prevented?' To address this question, we have evaluated the available data regarding nutritional and environmental factors that may be related to MS susceptibility and suggest the extent to which a potential intervention may reduce disease burden. It is our opinion that intervention, particularly supplementation with vitamin D, could have a dramatic impact on disease prevalence. Understanding that any intervention or behavioral modification will surely act in the context of genetic susceptibility and unidentified stochastic events, it is likely that not all MS is 'preventable'. Epidemiologic observation has provided key insights into environmental and nutritional factors that may alter one's susceptibility to MS, however, there are still many questions in unraveling the etiology of this complex disease.
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Affiliation(s)
- Kelly Claire Simon
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
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