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esfandiari F, Ghazaiean M, Darvishi-Khezri H, Baghbanian SM. Relationship between medical history and multiple sclerosis: A-case-control study. Medicine (Baltimore) 2023; 102:e33906. [PMID: 37335649 PMCID: PMC10256330 DOI: 10.1097/md.0000000000033906] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/11/2023] [Indexed: 06/21/2023] Open
Abstract
This project sought to explore the potential association between medical history and the development of multiple sclerosis (MS) by conducting a retrospective study. This population-based case-control study included 200 MS cases and 2 control groups of 200 patients and healthy individuals each. Data was collected through face-to-face interviews, medical file reviews, and an electronic checklist. Multivariable analysis was used to calculate odds ratios and 95% confidence intervals to estimate the risk of each medical history on MS occurrences. Of 600 participants, 381 (63.5%) individuals were female. The mean age of the participants was 36.5 ± 11.9 years. The adjusted risks of MS were 4.40; 95% CI: 1.73 to 11.1 for measles and 4.75; 95% CI: 2.05 to 11 for amoxicillin consumption. The adjusted MS odds for autoimmune disease including 4.63; 95% CI: 0.35 to 60.6 for psoriasis and 7.15; 95% CI: 1.87 to 27.2 for myasthenia gravis. On the other hand, the calculated adjusted odds of MS occurrence were 0.14; 95% CI: 0.03 to 0.69 for seizure and 0.17; 95% CI: 0.02 to 1.49 for epilepsy. This study suggested that individuals with autoimmune diseases should be monitored more closely, as they may be at an increased risk of developing other autoimmune conditions, particularly MS.
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Affiliation(s)
- Fatemeh esfandiari
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mobin Ghazaiean
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hadi Darvishi-Khezri
- Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Department of Research, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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2
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Rotstein DL, Wolfson C, Carruthers R, Freedman MS, Morrow SA, Lee L, Burton JM, Nisenbaum R, Konig A, Magalhaes S, Marrie RA. A national case-control study investigating demographic and environmental factors associated with NMOSD. Mult Scler 2023; 29:521-529. [PMID: 36803237 PMCID: PMC10152218 DOI: 10.1177/13524585231151953] [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] [Indexed: 02/20/2023]
Abstract
BACKGROUND Risk factors for aquaporin-4 (AQP4+) antibody neuromyelitis optica spectrum disorder (NMOSD) are not well-established. OBJECTIVE To investigate demographic and environmental factors associated with NMOSD using a validated questionnaire and case-control design. METHODS We enrolled patients with AQP4 + NMOSD through six Canadian Multiple Sclerosis Clinics. Participants completed the validated Environmental Risk Factors in Multiple Sclerosis Study (EnvIMS) questionnaire. Their responses were compared to those of 956 unaffected controls from the Canadian arm of EnvIMS. We calculated odds ratios (ORs) for the association between each variable and NMOSD using logistic regression and Firth's procedure for rare events. RESULTS In 122 participants (87.7% female) with NMOSD, odds of NMOSD in East Asian and Black participants were ⩾8 times that observed in White participants. Birthplace outside Canada was associated with an increased risk of NMOSD (OR = 5.5, 95% confidence interval (CI) = 3.6-8.3) as were concomitant autoimmune diseases (OR = 2.7, 95% CI = 1.4-5.0). No association was observed with reproductive history or age at menarche. CONCLUSION In this case-control study, risk of NMOSD in East Asian and Black versus White individuals was greater than that observed in many previous studies. Despite the preponderance of affected women, we did not observe any association with hormonal factors such as reproductive history or age at menarche.
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Affiliation(s)
- Dalia L Rotstein
- DL Rotstein MS Clinic, St. Michael’s
Hospital, 30 Bond St., Toronto, ON M5B 1W8, Canada.
| | - Christina Wolfson
- Departments of Epidemiology, Biostatistics and
Occupational Health and Medicine, Faculty of Medicine and Health Sciences,
McGill University, Montreal, QC, Canada/Research Institute of the McGill
University Health Centre, Montreal, QC, Canada
| | - Robert Carruthers
- Division of Neurology, Faculty of Medicine,
University of British Columbia, Vancouver, BC, Canada
| | - Mark S Freedman
- Department of Medicine, University of Ottawa,
Ottawa, ON, Canada/Ottawa Hospital Research Institute, Ottawa, ON,
Canada
| | - Sarah A Morrow
- Western University, London, ON, Canada/London
Health Sciences Centre, London, ON, Canada
| | - Liesly Lee
- Department of Medicine, University of Toronto,
Toronto, ON, Canada/Sunnybrook Health Sciences Centre, University of
Toronto, Toronto, ON, Canada
| | - Jodie M Burton
- Departments of Clinical Neurosciences and
Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Rosane Nisenbaum
- St. Michael’s Hospital, Toronto, ON,
Canada/Applied Health Research Centre and MAP Centre for Urban Health
Solutions, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity
Health Toronto, Toronto, ON, Canada/Division of Biostatistics, Dalla Lana
School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Sandra Magalhaes
- Department of Sociology, University of New
Brunswick, Fredericton, NB, Canada
| | - Ruth Ann Marrie
- Departments of Medicine and Community Health
Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences,
University of Manitoba, Winnipeg, MB, Canada
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Thomas OG, Rickinson A, Palendira U. Epstein-Barr virus and multiple sclerosis: moving from questions of association to questions of mechanism. Clin Transl Immunology 2023; 12:e1451. [PMID: 37206956 PMCID: PMC10191779 DOI: 10.1002/cti2.1451] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 05/21/2023] Open
Abstract
The link between Epstein-Barr virus (EBV) and multiple sclerosis (MS) has puzzled researchers since it was first discovered over 40 years ago. Until that point, EBV was primarily viewed as a cancer-causing agent, but the culmination of evidence now shows that EBV has a pivotal role in development of MS. Early MS disease is characterised by episodic neuroinflammation and focal lesions in the central nervous system (CNS) that over time develop into progressive neurodegeneration and disability. Risk of MS is vanishingly low in EBV seronegative individuals, history of infectious mononucleosis (acute symptomatic primary infection with EBV) significantly increases risk and elevated antibody titres directed against EBV antigens are well-characterised in patients. However, the underlying mechanism - or mechanisms - responsible for this interplay remains to be fully elucidated; how does EBV-induced immune dysregulation either trigger or drive MS in susceptible individuals? Furthermore, deep understanding of virological and immunological events during primary infection and long-term persistence in B cells will help to answer the many questions that remain regarding MS pathogenesis. This review discusses the current evidence and mechanisms surrounding EBV and MS, which have important implications for the future of MS therapies and prevention.
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Affiliation(s)
- Olivia G Thomas
- Department of Clinical Neuroscience, Therapeutic Immune Design, Centre for Molecular MedicineKarolinska InstituteStockholmSweden
| | - Alan Rickinson
- Institute of Cancer and Genomic Sciences, College of Medical and Dental SciencesUniversity of Birmingham, EdgbastonBirminghamUK
| | - Umaimainthan Palendira
- School of Medical Sciences, Faculty of Medicine and HealthThe University of SydneyCamperdownNSWAustralia
- Charles Perkins CentreThe University of SydneyCamperdownNSWAustralia
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4
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Mukharesh L, Douglas VP, Chwalisz BK. Chronic Relapsing Inflammatory Optic Neuropathy (CRION). Curr Opin Ophthalmol 2021; 32:521-526. [PMID: 34545844 DOI: 10.1097/icu.0000000000000804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Purpose of review
This review highlights the epidemiology, clinical and radiologic characteristics of chronic relapsing inflammatory optic neuropathy (CRION) and treatment modalities.
Recent findings
Summary
CRION is an inflammatory optic neuropathy that is characterized by a chronic and relapsing course, that is characterized by pain associated with subacute vision loss. It is favorably responsive but highly dependent on corticosteroids with frequent relapses in the setting of steroid tapering. Additional diagnostic biomarkers and further studies are required to better diagnose and treat this rare but potentially debilitating condition.
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Affiliation(s)
- Loulwah Mukharesh
- Department of Ophthalmology, Division of Neuro-Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Vivian Paraskevi Douglas
- Department of Ophthalmology, Division of Neuro-Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Bart K Chwalisz
- Department of Ophthalmology, Division of Neuro-Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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5
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Yang TT, Yin H, Liu PJ, Niu TT, Wang ZY, He Y, Yuan P, Zhang WW, Xu BL, Liu GZ. A preliminary study of association of cigarette smoking with risk of neuromyelitis optica spectrum disorder. Medicine (Baltimore) 2021; 100:e27234. [PMID: 34664866 PMCID: PMC8447994 DOI: 10.1097/md.0000000000027234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/05/2021] [Accepted: 08/26/2021] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Various studies have revealed an association between cigarette smoking and increased risk for multiple sclerosis (MS). However, its role in neuromyelitis optica spectrum disorder (NMOSD) remains elusive. Therefore, in the present case-control study, we aimed to assess the association of active and passive cigarette smoking with the risk of MS and NMOSD.Thirty-six patients with NMOSD, 46 patients with MS, and 122 healthy individuals were included in this study. Standardized questionnaires and telephone interviews were used to collect information regarding the active and passive cigarette smoking behaviors of the patients and normal controls.The risk of MS was significantly higher among smokers than among nonsmokers (odds ratio = 2.166, 95% confidence interval: 1.109-4.170; P = .027). Further analysis of the risk between active and passive smokers, male smokers and nonsmokers showed no statistical difference. However, neither smokers nor active smokers had a greater or lower risk of NMOSD than their nonsmoking counterparts.Our preliminary study showed no significant association between cigarette smoking and the risk of NMOSD, strongly suggesting that, unlike MS, cigarette smoking might not confer NMOSD susceptibility, at least in the Northern Han Chinese population.
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Affiliation(s)
- Ting-Ting Yang
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - He Yin
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Pen-Ju Liu
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Tian-Tong Niu
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ze-Yi Wang
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yang He
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Peng Yuan
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Wei-Wei Zhang
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Bao-Lei Xu
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Guang-Zhi Liu
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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6
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Rigi S, Shayanfar M, Mousavi SM, Mohammad-Shirazi M, Sharifi G, Esmaillzadeh A. Dietary phytochemical index in relation to risk of glioma: a case-control study in Iranian adults. Nutr J 2021; 20:31. [PMID: 33794889 PMCID: PMC8017633 DOI: 10.1186/s12937-021-00689-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 03/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND & AIM No study is available that explores the association of dietary phytochemical index (DPI) with glioma. The objective of the current study was to assess this association in Iranian adults. METHODS This hospital-based case-control study included 128 newly-diagnosed cases of glioma and 256 age- and sex-matched controls. Data collection on dietary intakes was done using a 123-item validated food frequency questionnaire. Calculation of DPI was done as (dietary energy derived from phytochemical-rich foods (kcal)/total daily energy intake (kcal)) × 100. Logistic regression models were used to examine the association between DPI and glioma. RESULTS Individuals in the top tertile of DPI were more likely to be older and female. Before taking potential confounders into account, subjects in the top tertile of DPI tended to have a 40% reduced chance of glioma than those in the bottom tertile (OR: 0.60; 95% CI: 0.35-1.02, P = 0.06). After controlling for age, sex, energy intake, several demographic variables and dietary intakes, the association between DPI and glioma became strengthened (OR: 0.43; 95% CI: 0.19-0.97, P = 0.04). CONCLUSION High intakes of phytochemical-rich foods were associated with a lower risk of glioma in adults. High consumption of phytochemical-rich foods might be recommended to prevent glioma. However, further studies with a prospective design are needed to confirm our findings.
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Affiliation(s)
- Somaye Rigi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Mehdi Shayanfar
- Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Mousavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Minoo Mohammad-Shirazi
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Giuve Sharifi
- Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Community Nutrition, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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7
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Abstract
IMPORTANCE Multiple sclerosis (MS) is an autoimmune-mediated neurodegenerative disease of the central nervous system characterized by inflammatory demyelination with axonal transection. MS affects an estimated 900 000 people in the US. MS typically presents in young adults (mean age of onset, 20-30 years) and can lead to physical disability, cognitive impairment, and decreased quality of life. This review summarizes current evidence regarding diagnosis and treatment of MS. OBSERVATIONS MS typically presents in young adults aged 20 to 30 years with unilateral optic neuritis, partial myelitis, sensory disturbances, or brainstem syndromes such as internuclear ophthalmoplegia developing over several days. The prevalence of MS worldwide ranges from 5 to 300 per 100 000 people and increases at higher latitudes. Overall life expectancy is less than in the general population (75.9 vs 83.4 years), and MS more commonly affects women (female to male sex distribution of nearly 3:1). Diagnosis is made based on a combination of signs and symptoms, radiographic findings (eg, magnetic resonance imaging [MRI] T2 lesions), and laboratory findings (eg, cerebrospinal fluid-specific oligoclonal bands), which are components of the 2017 McDonald Criteria. Nine classes of disease-modifying therapies (DMTs), with varying mechanisms of action and routes of administration, are available for relapsing-remitting MS, defined as relapses at onset with stable neurologic disability between episodes, and secondary progressive MS with activity, defined as steadily increasing neurologic disability following a relapsing course with evidence of ongoing inflammatory activity. These drugs include interferons, glatiramer acetate, teriflunomide, sphingosine 1-phosphate receptor modulators, fumarates, cladribine, and 3 types of monoclonal antibodies. One additional DMT, ocrelizumab, is approved for primary progressive MS. These DMTs reduce clinical relapses and MRI lesions (new T2 lesions, gadolinium-enhancing lesions). Efficacy rates of current DMTs, defined by reduction in annualized relapse rates compared with placebo or active comparators, range from 29%-68%. Adverse effects include infections, bradycardia, heart blocks, macular edema, infusion reactions, injection-site reactions, and secondary autoimmune adverse effects, such as autoimmune thyroid disease. CONCLUSIONS AND RELEVANCE MS is characterized by physical disability, cognitive impairment, and other symptoms that affect quality of life. Treatment with DMT can reduce the annual relapse rate by 29% to 68% compared with placebo or active comparator.
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Affiliation(s)
| | | | - Alexander D Rae-Grant
- Cleveland Clinic Mellen Center, Cleveland, Ohio
- Now with Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
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8
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Messina S, Mariano R, Geraldes R, Kim SH, Satukijcha C, Vecchio D, Chua YY, Taylor J, George N, Cavey A, Diaz AR, Reeve S, Everett R, De Luca G, Leite MI, Kim HJ, Palace J. The influence of smoking on the pattern of disability and relapse risk in AQP4-positive Neuromyelitis Optica Spectrum Disorder, MOG-Ab Disease and Multiple Sclerosis. Mult Scler Relat Disord 2021; 49:102773. [PMID: 33540279 DOI: 10.1016/j.msard.2021.102773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/06/2021] [Accepted: 01/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND the role of smoking on clinical outcomes of central nervous system (CNS) inflammatory disorders is unclear. To assess the effect of smoking on relapses and disability in neuromyelitis optica with aquaporin-4-antibodies (NMOSD-AQP4-Ab), Myelin Oligodendrocyte Glycoprotein-antibodies associated disease (MOGAD) and relapsing remitting Multiple Sclerosis (MS) patients. METHODS in a UK cohort of 101 NMOSD-AQP4-Ab, 70 MOGAD and 159 MS, and a Korean cohort of 97 NMOSD-AQ4-Ab, time to first relapse, annualised relapse rate, onset relapse severity and recovery, time to Expanded Disability Status Score(EDSS)/secondary progressive MS (SPMS) were compared between never-smokers and ever-smokers. All clinical data were collected under the local ethics between January 2017 and January 2019. RESULTS Smoking did not affect the risk of relapse in any of the diseases. The risk of reaching EDSS 6.0 in the UK NMOSD-AQP4-Ab cohort was higher in ever smokers but this did not achieve significance (HR 2.12, p=0.068). When combining the UK and Korea NMOSD-AQP4-Ab cohorts, poorer recovery from the onset attack was significantly more frequent in the ever-smokers versus the never smokers (55% vs 38%, p=0.04). In the MS cohort the risk of reaching EDSS 6 and SPMS was significantly higher in the ever-smokers (HR=2.67, p=0.01 and HR=3.18, p=0.001). In MOGAD similar patterns were seen without reaching significance. CONCLUSIONS In NMOSD-AQP4-Ab smoking associates with worse disability not through an increased risk of relapses but through poor relapse recovery. As in MS, smoking cessation should be encouraged in NMOSD-AQP4-Ab.
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Affiliation(s)
- Silvia Messina
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK; Department of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK. https://twitter.com/silvia06
| | - Romina Mariano
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Ruth Geraldes
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK; Department of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK
| | - Su-Hyun Kim
- Department of Neurology, Research Institute and Hospital of National Cancer, Goyang, Korea
| | - Chanjira Satukijcha
- Division of Neurology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand; Bangkok Hospital Headquarters, BDMS, Bangkok, 10310, Thailand
| | | | - Yi Yi Chua
- Department of Neurology, University of Piemonte Orientale, Novara, Italy; Oxford Medical School, University of Oxford, Oxford, UK
| | - James Taylor
- Department of Neurology, University of Piemonte Orientale, Novara, Italy; Oxford Medical School, University of Oxford, Oxford, UK
| | - Naveen George
- Department of Neurology, University of Piemonte Orientale, Novara, Italy; Oxford Medical School, University of Oxford, Oxford, UK
| | - Ana Cavey
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK; Department of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK
| | - Alejandro Rubio Diaz
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Sandra Reeve
- Department of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK
| | - Rosie Everett
- Department of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK
| | - Gabriele De Luca
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK; Department of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK
| | - Maria Isabel Leite
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK; Department of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK
| | - Ho Jin Kim
- Department of Neurology, Research Institute and Hospital of National Cancer, Goyang, Korea
| | - Jacqueline Palace
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK; Department of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK.
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Barzegar M, Mirmosayyeb O, Nehzat N, Vaheb S, Shaygannejad V, Asgari N. Frequency of comorbidities in Neuromyelitis Optica spectrum disorder. Mult Scler Relat Disord 2020; 48:102685. [PMID: 33321342 DOI: 10.1016/j.msard.2020.102685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/13/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Comorbidity may influence clinical aspects of neuromyelitis optica spectrum disorder (NMOSD). We estimated the prevalence of comorbidities to assess their association with outcomes. METHODS This retrospective study assessed records of NMOSD patients from 2008 to 2019, categorizing comorbidities into three groups: somatic, psychiatric and autoimmune. Severity of disease was evaluated by the Expanded Disability Status Scale, progression index (PI) and annualized relapse rate. The frequency of comorbidities was compared between anti-aquaporin 4 antibody (AQP4-IgG) seropositive and seronegative patients. RESULTS A total of 67 NMOSD patients were enrolled. Thirty-five (52.2%) patients reported at least one comorbidity. In total, 44 comorbidities were found, of which 24 occurred prior to NMOSD onset: 29 somatic, 13 psychiatric and 2 autoimmune entities. The most common comorbidities were anxiety disorders 7/67 (10.4%), followed by migraine 6/67 (8.9%) major depression disorder 6/67 (8.9%), iron deficiency anemia 8/54 (14.8%), and non-autoimmune hypothyroidism 4/67 (6.0%). Psychiatric comorbidities associated with PI in unadjusted (OR=0.538, 95% CI=0.141, 0.935, P=0.009) and adjusted models (OR=0.386, 95% CI=0.022, 0.751, P=0.038). A significantly higher frequency of psychiatric comorbidities was observed in the AQP4-IgG positive patients (P=0.031). CONCLUSION Half of the patients had comorbidities, suggesting screening for comorbidity as part of NMOSD care. The psychiatric comorbidities had impact on clinical outcome.
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Affiliation(s)
- Mahdi Barzegar
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Omid Mirmosayyeb
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Nasim Nehzat
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Saeed Vaheb
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Vahid Shaygannejad
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Nasrin Asgari
- Department of Neurology, Slagelse Hospital, Institute of Regional Health Research, Denmark; Department of Neurobiology, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
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10
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Hedström AK, Huang J, Brenner N, Butt J, Hillert J, Waterboer T, Kockum I, Olsson T, Alfredsson L. Smoking and Epstein-Barr virus infection in multiple sclerosis development. Sci Rep 2020; 10:10960. [PMID: 32620875 PMCID: PMC7335184 DOI: 10.1038/s41598-020-67883-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 05/29/2020] [Indexed: 11/09/2022] Open
Abstract
It is unclear whether smoking interacts with different aspects of Epstein-Barr virus (EBV) infection with regard to multiple sclerosis (MS) risk. We aimed to investigate whether smoking acts synergistically with elevated EBNA-1 antibody levels or infectious mononucleosis (IM) history regarding MS risk. Two Swedish population-based case-control studies were used (6,340 cases and 6,219 matched controls). Subjects with different smoking, EBNA-1 and IM status were compared regarding MS risk, by calculating odds ratios (OR) with 95% confidence intervals (CI) employing logistic regression. Potential interaction on the additive scale was evaluated by calculating the attributable proportion due to interaction (AP). Current and past smokers had higher EBNA-1 antibody levels than never smokers (p < 0.0001). There was an additive interaction between current smoking and high EBNA-1 antibody levels (AP 0.3, 95% CI 0.2-0.4), but not between past smoking and high EBNA-1 antibody levels (AP 0.01, 95% CI - 0.1 to 0.1), with regard to MS risk. An interaction also occurred between current smoking and IM history (AP 0.2, 95% CI 0.004-0.4), but not between past smoking and IM history (AP - 0.06, 95% CI - 0.4 to 0.3). Current smoking increases EBNA-1 antibody levels and acts synergistically with both aspects of EBV infection to increase MS risk, indicating that there is at least one pathway to disease in which both risk factors are involved.
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Affiliation(s)
- Anna Karin Hedström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. .,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Jesse Huang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
| | - Nicole Brenner
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Julia Butt
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jan Hillert
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
| | - Tim Waterboer
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ingrid Kockum
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
| | - Tomas Olsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
| | - Lars Alfredsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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11
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Abstract
Multiple sclerosis (MS) is a common, severe neurological disease that affects millions of people worldwide. Nevertheless, the actual cause of MS remains unknown. Smoking has been studied with respect to MS development and progression. The objectives of this review were to examine the relationship between smoking and MS and to understand the possible molecular mechanisms underlying the association. PubMed was searched for articles related to the study topic published between 2012 and 2020 using the search terms "multiple sclerosis," "smoking," "risk factors," "cigarettes," and "molecular mechanisms." Studies show a significant relationship between smoking and the risk of MS. Furthermore, smoking has been linked to the progression of MS at the patient and population levels. However, the underlying mechanism remains to be explored in further studies; researchers still disagree on how the relationship between smoking and MS arises in different populations. Evidence from randomized controlled trials, systematic reviews, and epidemiological studies shows that smokers have a higher risk of developing MS and experiencing related adverse symptoms and complications.
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Affiliation(s)
- Borros Arneth
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Hospital of the Universities of Giessen and Marburg UKGM, Justus Liebig University Giessen, Giessen, Hessen Germany.
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12
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Naser Moghadasi A. Environmental and genetic risk factors in the development of neuromyelitis optica. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2020.1723416] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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13
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Zarei S, Eggert J, Franqui-Dominguez L, Carl Y, Boria F, Stukova M, Avila A, Rubi C, Chinea A. Comprehensive review of neuromyelitis optica and clinical characteristics of neuromyelitis optica patients in Puerto Rico. Surg Neurol Int 2018; 9:242. [PMID: 30603227 PMCID: PMC6293609 DOI: 10.4103/sni.sni_224_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 08/21/2018] [Indexed: 12/14/2022] Open
Abstract
Neuromyelitis optica (NMO) is an immune-mediated inflammatory disorder of the central nervous system. It is characterized by concurrent inflammation and demyelination of the optic nerve (optic neuritis [ON]) and the spinal cord (myelitis). Multiple studies show variations in prevalence, clinical, and demographic features of NMO among different populations. In addition, ethnicity and race are known as important factors on disease phenotype and clinical outcomes. There are little data on information about NMO patients in underserved groups, including Puerto Rico (PR). In this research, we will provide a comprehensive overview of all aspects of NMO, including epidemiology, environmental risk factors, genetic factors, molecular mechanism, symptoms, comorbidities and clinical differentiation, diagnosis, treatment, its management, and prognosis. We will also evaluate the demographic features and clinical phenotype of NMO patients in PR. This will provide a better understanding of NMO and establish a basis of knowledge that can be used to improve care. Furthermore, this type of population-based study can distinguish the clinical features variation among NMO patients and will provide insight into the potential mechanisms that cause these variations.
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Affiliation(s)
- Sara Zarei
- San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA
| | - James Eggert
- San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA
| | | | - Yonatan Carl
- San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA
| | - Fernando Boria
- San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA
| | - Marina Stukova
- San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA
| | | | - Cristina Rubi
- Caribbean Neurological Center, Guaynabo, Puerto Rico, USA
| | - Angel Chinea
- Caribbean Neurological Center, Guaynabo, Puerto Rico, USA
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14
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Saroufim P, Zweig SA, Conway DS, Briggs FBS. Cardiovascular conditions in persons with multiple sclerosis, neuromyelitis optica and transverse myelitis. Mult Scler Relat Disord 2018; 25:21-25. [PMID: 30014877 DOI: 10.1016/j.msard.2018.07.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/02/2018] [Accepted: 07/06/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cardiovascular conditions are associated with poorer outcomes in multiple sclerosis (MS). Whether the burden of cardiovascular conditions differs between those with demyelinating disease and unaffected controls is not clear. The objective of this study is to investigate the burden and age of onset of cardiovascular conditions in a US population with MS, neuromyelitis optica spectrum disorder (NMOSD), or transverse myelitis (TM) to unaffected controls adjusting for likely confounders. METHODS Using a case-control study design, we compared the burden of self-reported diabetes mellitus type 2, heart disease, hyperlipidemia, and hypertension in cases with MS (N = 1,548), NMOSD (N = 306), and TM (N = 145) to controls (N = 677), adjusting for demographics, smoking history, obesity, family history of individual cardiovascular conditions, and presence of other cardiovascular conditions. The age of onset for individual cardiovascular conditions were also compared between cases and controls. RESULTS MS cases were 48% more likely to have ever had hypertension than controls (p = 0.01). The prevalence of other cardiovascular conditions did not differ across cases and controls. There were also no differences in the age of cardiovascular disease onset between cases and controls. CONCLUSION Cardiovascular conditions are as common in those with demyelinating diseases compared to unaffected individuals, with hypertension being more common among those with MS.
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Affiliation(s)
- Paola Saroufim
- Neuroimmunological Disorders Gene-Environment Epidemiology Laboratory, Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States; Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, United States
| | - Sophia A Zweig
- Neuroimmunological Disorders Gene-Environment Epidemiology Laboratory, Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Devon S Conway
- The Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, United States
| | - Farren B S Briggs
- Neuroimmunological Disorders Gene-Environment Epidemiology Laboratory, Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States.
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15
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Poorolajal J, Bahrami M, Karami M, Hooshmand E. Effect of smoking on multiple sclerosis: a meta-analysis. J Public Health (Oxf) 2018; 39:312-320. [PMID: 27160862 DOI: 10.1093/pubmed/fdw030] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background Despite our awareness of the significant effect of smoking on multiple sclerosis (MS), there was a serious lack of information about the effect of different types of smoking habit on MS as well as the dose-response relationship between smoking and MS, but this gap was addressed by this meta-analysis. Methods Major electronic databases, including PubMed, Web of Science and Scopus were searched until July 2015. Epidemiological studies addressing the association between smoking and MS were enrolled. The heterogeneity across studies was investigated by Q-test and I2 statistic. The probability of publication bias was explored using Begg's and Egger's tests. The results were expressed as odds ratio (OR) with 95% confidence intervals (CI) using a random effects model. Results We identified a total of 10 687 references and included 34 studies involving 623 852 participants. Compared with nonsmokers, the OR estimate of MS was 1.46 (1.33, 1.59) among ever smokers, 1.57 (1.34, 1.80) among current smokers, 1.36 (1.27, 1.46) among ex-smokers and 1.12 (0.87, 1.36) among passive smokers. In addition, analyzing the effect of cigarette pack-year on MS indicated that the OR estimate of MS was 1.34 (1.06, 1.61) for 1-5 cigarette pack-years, 1.56 (1.15, 1.97) for 6-10 cigarette pack-years, 1.74 (1.16, 2.33) for 11-15 cigarette pack-years and 1.46 (0.49, 2.43) for more than 15 cigarette pack-years. Conclusions Smoking habits are significantly associated with MS, although the association is not very strong. However, there is a dose-response relationship between the smoking habits and MS.
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Affiliation(s)
- Jalal Poorolajal
- Modeling of Noncommunicable Diseases Research Center, Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masoud Bahrami
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan 651783869, Iran
| | - Manoochehr Karami
- Social Determinants of Health Research Center (SDHRC) and Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Elham Hooshmand
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan 651783869, Iran
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16
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Degelman ML, Herman KM. Smoking and multiple sclerosis: A systematic review and meta-analysis using the Bradford Hill criteria for causation. Mult Scler Relat Disord 2017; 17:207-216. [DOI: 10.1016/j.msard.2017.07.020] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 07/18/2017] [Accepted: 07/21/2017] [Indexed: 11/26/2022]
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17
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Bjørnevik K, Riise T, Bostrom I, Casetta I, Cortese M, Granieri E, Holmøy T, Kampman MT, Landtblom AM, Magalhaes S, Pugliatti M, Wolfson C, Myhr KM. Negative interaction between smoking and EBV in the risk of multiple sclerosis: The EnvIMS study. Mult Scler 2016; 23:1018-1024. [DOI: 10.1177/1352458516671028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background: Results from previous studies on a possible interaction between smoking and Epstein–Barr virus (EBV) in the risk of multiple sclerosis (MS) are conflicting. Objectives: To examine the interaction between smoking and infectious mononucleosis (IM) in the risk of MS. Methods: Within the case–control study on Environmental Factors In Multiple Sclerosis (EnvIMS), 1904 MS patients and 3694 population-based frequency-matched healthy controls from Norway, Italy, and Sweden reported on prior exposure to smoking and history of IM. We examined the interaction between the two exposures on the additive and multiplicative scale. Results: Smoking and IM were each found to be associated with an increased MS risk in all three countries, and there was a negative multiplicative interaction between the two exposures in each country separately as well as in the pooled analysis ( p = 0.001). Among those who reported IM, there was no increased risk associated with smoking (odds ratio (OR): 0.95, 95% confidence interval (CI): 0.66–1.37). The direction of the estimated interactions on the additive scale was consistent with a negative interaction in all three countries (relative excess risk due to interaction (RERI): −0.98, 95% CI: −2.05–0.15, p = 0.09). Conclusion: Our findings indicate competing antagonism, where the two exposures compete to affect the outcome.
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Affiliation(s)
- Kjetil Bjørnevik
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway/The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Trond Riise
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway/The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Inger Bostrom
- Division of Neurology, Department of Clinical and Experimental Medicine, University of Linköping, Linköping, Sweden
| | - Ilaria Casetta
- Department of Biomedical and Specialist Surgical Sciences, Section of Clinical Neurology, University of Ferrara, Ferrara, Italy
| | - Marianna Cortese
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway/The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Enrico Granieri
- Department of Biomedical and Specialist Surgical Sciences, Section of Clinical Neurology, University of Ferrara, Ferrara, Italy
| | - Trygve Holmøy
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway/Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Margitta T Kampman
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Anne-Marie Landtblom
- Division of Neurology, Department of Clinical and Experimental Medicine, University of Linköping, Linköping, Sweden/Department of Neuroscience/Neurology, Uppsala University, Uppsala, Sweden
| | - Sandra Magalhaes
- Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Maura Pugliatti
- Department of Biomedical and Specialty Surgical Sciences, Section of Clinical Neurology, University of Ferrara, Ferrara, Italy/Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Christina Wolfson
- Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada/Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Kjell-Morten Myhr
- The Kristian Gerhard Jebsen Centre for MS-Research, Department of Clinical Medicine, University of Bergen, Bergen, Norway/The Norwegian Multiple Sclerosis Registry and Biobank, Department of Neurology, Haukeland University Hospital, Bergen, Norway
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18
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Verduin EP, Brand A, van de Watering LMG, Roelen DL, Kanhai HHH, Doxiadis IIN, Claas FHJ, Schonewille H. The HLA-DRB1*15 phenotype is associated with multiple red blood cell and HLA antibody responsiveness. Transfusion 2016; 56:1849-56. [PMID: 27185287 DOI: 10.1111/trf.13648] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/07/2016] [Accepted: 04/04/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Once a patient has produced a red blood cell (RBC) antibody, there is an increased risk of additional antibody formation after subsequent RBC exposure. Recently, we observed that HLA-DRB1*15 was overrepresented in 379 multiple RBC antibody responders compared to controls or 562 patients with a single RBC antibody (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.3-2.3). In this study we evaluated whether the HLA-DRB1*15 represents a responder phenotype against HLA and/or RBC antigens. STUDY DESIGN AND METHODS HLA-DRB1*15 frequencies in single and multiple antibody responders were compared between three groups of individuals: 1) those with HLA antibodies, 2) those with RBC antibodies, and 3) those with both RBC and HLA antibodies. RESULTS A total of 3959 immunized patients (female-to-male ratio, 2.3) had been HLA-DRB1 typed. Among the 3275 individuals with HLA antibodies, the frequency of the DRB1*15 phenotype differed significantly from 19.7% in patients with a panel reactivity (PRA) of not more than 20% to 26.9% in patients with PRA of more than 80% (OR, 1.5; 95% CI, 1.2-1.9). This association between DRB1*15 and multiresponsiveness was mainly due to pregnancy-induced HLA immunization. In the 257 individuals with RBC and HLA antibodies, the frequency of DRB1*15 was 4.2 times (95% CI, 1.1-16) higher in those with multiple RBC antibodies and HLA-PRA of more than 50% compared to only single RBC responders with PRA of less than 20%. CONCLUSION The HLA-DRB1*15 phenotype is associated with broad RBC and HLA immunization.
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Affiliation(s)
- Esther P Verduin
- Center for Clinical Transfusion Research.,Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.,Jon J. van Rood Center for Clinical Transfusion Research, Sanquin-Leiden University Medical Center, Leiden, The Netherlands
| | - Anneke Brand
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.,Jon J. van Rood Center for Clinical Transfusion Research, Sanquin-Leiden University Medical Center, Leiden, The Netherlands
| | - Leo M G van de Watering
- Center for Clinical Transfusion Research.,Jon J. van Rood Center for Clinical Transfusion Research, Sanquin-Leiden University Medical Center, Leiden, The Netherlands
| | - Dave L Roelen
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | - Humphrey H H Kanhai
- Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Ilias I N Doxiadis
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | - Frans H J Claas
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | - Henk Schonewille
- Center for Clinical Transfusion Research.,Jon J. van Rood Center for Clinical Transfusion Research, Sanquin-Leiden University Medical Center, Leiden, The Netherlands
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19
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Zhang P, Wang R, Li Z, Wang Y, Gao C, Lv X, Song Y, Li B. The risk of smoking on multiple sclerosis: a meta-analysis based on 20,626 cases from case-control and cohort studies. PeerJ 2016; 4:e1797. [PMID: 27014514 PMCID: PMC4806598 DOI: 10.7717/peerj.1797] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 02/22/2016] [Indexed: 12/31/2022] Open
Abstract
Background. Multiple sclerosis (MS) has become a disease that represents a tremendous burden on patients, families, and societies. The exact etiology of MS is still unclear, but it is believed that a combination of genetic and environmental factors contribute to this disease. Although some meta-analyses on the association between smoking and MS have been previously published, a number of new studies with larger population data have published since then. Consequently, these additional critical articles need to be taken into consideration. Method. We reviewed articles by searching in PubMed and EMBASE. Both conservative and non-conservative models were used to investigate the association between smoking and the susceptibility to MS. We also explored the effect of smoking on the susceptibility to MS in strata of different genders and smoking habits. The association between passive smoking and MS was also explored. Results.The results of this study suggest that smoking is a risk factor for MS (conservative model: odds ratio (OR) 1.55, 95% CI [1.48–1.62], p < 0.001; non-conservative model: 1.57, 95% CI [1.50–1.64], p < 0.001). Smoking appears to increase the risk of MS more in men than in women and in current smokers more than in past smokers. People who exposed to passive smoking have higher risk of MS than those unexposed. Conclusion.This study demonstrated that exposure to smoking is an important risk factor for MS. People will benefit from smoking cessation, and policymakers should pay attention to the association between smoking and MS.
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Affiliation(s)
- Peng Zhang
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health , Changchun , China
| | - Rui Wang
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health , Changchun , China
| | - Zhijun Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health , Changchun , China
| | - Yuhan Wang
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health , Changchun , China
| | - Chunshi Gao
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health , Changchun , China
| | - Xin Lv
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health , Changchun , China
| | - Yuanyuan Song
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health , Changchun , China
| | - Bo Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health , Changchun , China
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20
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Xia Z, White CC, Owen EK, Von Korff A, Clarkson SR, McCabe CA, Cimpean M, Winn PA, Hoesing A, Steele SU, Cortese ICM, Chitnis T, Weiner HL, Reich DS, Chibnik LB, De Jager PL. Genes and Environment in Multiple Sclerosis project: A platform to investigate multiple sclerosis risk. Ann Neurol 2015; 79:178-89. [PMID: 26583565 DOI: 10.1002/ana.24560] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 10/21/2015] [Accepted: 11/14/2015] [Indexed: 11/06/2022]
Abstract
The Genes and Environment in Multiple Sclerosis project establishes a platform to investigate the events leading to multiple sclerosis (MS) in at-risk individuals. It has recruited 2,632 first-degree relatives from across the USA. Using an integrated genetic and environmental risk score, we identified subjects with twice the MS risk when compared to the average family member, and we report an initial incidence rate in these subjects that is 30 times greater than that of sporadic MS. We discuss the feasibility of large-scale studies of asymptomatic at-risk subjects that leverage modern tools of subject recruitment to execute collaborative projects.
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Affiliation(s)
- Zongqi Xia
- Program in Translational Neuropsychiatric Genomics and Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
| | - Charles C White
- Program in Translational Neuropsychiatric Genomics and Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, MA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
| | - Emily K Owen
- Program in Translational Neuropsychiatric Genomics and Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Alina Von Korff
- Program in Translational Neuropsychiatric Genomics and Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Sarah R Clarkson
- Program in Translational Neuropsychiatric Genomics and Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Cristin A McCabe
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
| | - Maria Cimpean
- Program in Translational Neuropsychiatric Genomics and Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Phoebe A Winn
- Program in Translational Neuropsychiatric Genomics and Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Ashley Hoesing
- Program in Translational Neuropsychiatric Genomics and Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Sonya U Steele
- Division of Neuroimmunology and Neurovirology, National Institute for Neurologic Diseases and Stroke, Bethesda, MD
| | - Irene C M Cortese
- Division of Neuroimmunology and Neurovirology, National Institute for Neurologic Diseases and Stroke, Bethesda, MD
| | - Tanuja Chitnis
- Program in Translational Neuropsychiatric Genomics and Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Howard L Weiner
- Program in Translational Neuropsychiatric Genomics and Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Daniel S Reich
- Division of Neuroimmunology and Neurovirology, National Institute for Neurologic Diseases and Stroke, Bethesda, MD
| | - Lori B Chibnik
- Program in Translational Neuropsychiatric Genomics and Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
| | - Philip L De Jager
- Program in Translational Neuropsychiatric Genomics and Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
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21
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Yin J, Long Y, Shan F, Fan Y, Wu L, Zhong R, Gao C, Chen X, Gao Q, Yang N. Clinical manifestations of neuromyelitis optica in male and female patients. Neurol Res 2015. [PMID: 26213113 DOI: 10.1179/1743132815y.0000000081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Neuromyelitis optica (NMO) is a severe, idiopathic, immuno-mediated, inflammatory demyelinating disease of the central nervous system. We examined the clinical features between male and female NMO patients, for which not much data exist. One hundred and eight Chinese Han patients with NMO were analysed retrospectively, all had been detected for the aquaporin-4 (AQP4) antibody using a cell-based assay. Of 108 NMO patients, 92 were female and 16 were male (female/male = 5.75). Ninety-four (87%) were positive for the AQP4 antibody in their serum and/or cerebral spinal fluid. Aquaporin-4 antibody-positive NMO patients had a higher female/male ratio than the negative group (P = 0.001). Female NMO patients had a higher positive rate of the AQP4 antibody than male NMO patients (92.4 vs 56.3%, P = 0.001). All NMO male patients were divided according to their AQP4 antibody status. 77.8% (7/9) of patients in the seropositive group had initial optic neuritis, while only one patient (14.3%, 1/7) in the negative group had optic neuritis (P = 0.041). Limb paraesthesia was reported in only one patient in the negative group (11.1%), but it was reported in all patients in the positive group (100%) (P = 0.001). The mean length of vertebral segments of the spinal cord lesions was 3.6 ± 1.3 in the positive group, while it was 6.6 ± 2.6 in the negative group (P < 0.0001). The involvement of the cervical spinal cord was found in 88.9% (8/9) of the positive members, but only 11.1% in the negative group (P = 0.009). However, the involvement of the thoracic spinal cord was found in 22.2% of patients in the positive group and 85.7% of patients in the negative members (P = 0.041). In conclusion, male NMO is rare and has a low positive rate of AQP4 antibody.
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