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Bose A, Khalighinejad F, Hoaglin DC, Hemond CC. Evaluating the Clinical Utility of Epstein-Barr Virus Antibodies as Biomarkers in Multiple Sclerosis: A Systematic Review. Mult Scler Relat Disord 2024; 84:105410. [PMID: 38401201 DOI: 10.1016/j.msard.2023.105410] [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: 08/18/2023] [Revised: 12/14/2023] [Accepted: 12/23/2023] [Indexed: 02/26/2024]
Abstract
BACKGROUND EBV is a necessary but not sufficient factor in the pathophysiology of multiple sclerosis (MS). EBV antibodies to the nuclear antigen (EBNA1) and viral capsid antigen (VCA) rise rapidly prior to MS disease manifestations, and their absence has clinical utility with a high negative predictive value. It remains unclear whether EBV levels act as prognostic, monitoring, or pharmacodynamic/response biomarkers. Substantial literature on this topic exists but has not been systematically reviewed. We hypothesized that EBV levels against EBNA1 and VCA are potential prognostic and monitoring biomarkers in MS, and that patient population, MS clinical phenotype, and EBV assay method may play important roles in explaining variation among study outcomes. METHODS We systematically searched PubMed and EMBASE from inception to April 1, 2022. After removal of duplicates, records were screened by abstract. Remaining full-text articles were reviewed. Clinical and MRI data were extracted from full-text articles for comparison and synthesis. RESULTS Searches yielded 696 unique results; 285 were reviewed in full, and 36 met criteria for data extraction. Heterogeneity in sample population, clinical outcome measures, assay methods and statistical analyses precluded a meta-analysis. EBV levels were not consistently associated with clinical disease markers including conversion from CIS to RRMS, neurological disability, or disease phenotype. Studies using repeated-measures design suggest that EBNA1 levels may temporarily reflect inflammatory disease activity as assessed by gadolinium-enhancing Magnetic Resonance Imaging (MRI) lesions. Limited data also suggest a decrease in EBV levels following initiation of certain disease-modifying therapies. CONCLUSION Heterogeneous methodology limited generalization and meta-analysis. EBV antibody levels are unlikely to represent prognostic biomarkers in MS. The areas of highest ongoing promise relate to diagnostic exclusion and pharmacodynamic/disease response. Use of EBV antibodies as biomarkers in clinical practice remains additionally limited by lack of methodological precision, reliability, and validation.
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Affiliation(s)
- Abigail Bose
- University of Massachusetts Chan Medical School.
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2
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Wahbeh F, Restifo D, Laws S, Pawar A, Parikh NS. Impact of tobacco smoking on disease-specific outcomes in common neurological disorders: A scoping review. J Clin Neurosci 2024; 122:10-18. [PMID: 38428126 DOI: 10.1016/j.jocn.2024.02.013] [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: 11/06/2023] [Revised: 01/27/2024] [Accepted: 02/12/2024] [Indexed: 03/03/2024]
Abstract
Although the association of smoking with the risk of incident neurological disorders is well established, less is known about the impact of smoking and smoking cessation on outcomes of these conditions. The objective of this scoping review was to synthesize what is known about the impact of smoking and smoking cessation on disease-specific outcomes for seven common neurological disorders. We included 67 studies on the association of smoking and smoking cessation on disease-specific outcomes. For multiple sclerosis, smoking was associated with greater clinical and radiological disease progression, relapses, risk for disease-related death, cognitive decline, and mood symptoms, in addition to reduced treatment effectiveness. For stroke and transient ischemic attack, smoking was associated with greater rates of stroke recurrence, post-stroke cardiovascular outcomes, post-stroke mortality, post-stroke cognitive impairment, and functional impairment. In patients with cognitive impairment and dementia, smoking was associated with faster cognitive decline, and smoking was also associated with greater cognitive decline in Parkinson's disease, but not motor symptom worsening. Patients with amyotrophic lateral sclerosis who smoked faced increased mortality. Last, in patients with cluster headache, smoking was associated with more frequent and longer cluster attack periods. Conversely, for multiple sclerosis and stroke, smoking cessation was associated with improved disease-specific outcomes. In summary, whereas smoking is detrimentally associated with disease-specific outcomes in common neurological conditions, there is growing evidence that smoking cessation may improve outcomes. Effective smoking cessation interventions should be leveraged in the management of common neurological disorders to improve patient outcomes.
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Affiliation(s)
- Farah Wahbeh
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Daniel Restifo
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Sa'ad Laws
- Education and Research, Health Sciences Library, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Anokhi Pawar
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Neal S Parikh
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA.
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3
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Zhu N, Zhu J, Lin S, Yu H, Cao C. Correlation analysis between smoke exposure and serum neurofilament light chain in adults: a cross-sectional study. BMC Public Health 2024; 24:353. [PMID: 38308244 PMCID: PMC10835908 DOI: 10.1186/s12889-024-17811-8] [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: 11/15/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Smoke exposure is a prevalent and well-documented risk factor for various diseases across different organ systems. Serum neurofilament light chain (sNfL) has emerged as a promising biomarker for a multitude of nervous system disorders. However, there is a notable paucity of research exploring the associations between smoke exposure and sNfL levels. METHODS We conducted a comprehensive analysis of the National Health and Nutrition Examination Survey (NHANES) cross-sectional data spanning the years 2013 to 2014. Serum cotinine levels were classified into the following three groups: < 0.05, 0.05-2.99, and ≥ 3 ng/ml. Multiple linear regression models were employed to assess the relationships between serum cotinine levels and sNfL levels. Additionally, we utilized restricted cubic spline analyses to elucidate the potential nonlinear relationship between serum cotinine and sNfL levels. RESULTS A total of 2053 participants were included in our present research. Among these individuals, the mean age was 47.04 ± 15.32 years, and males accounted for 48.2% of the total study population. After adjusting the full model, serum cotinine was positively correlated with sNfl in the second group (β = 0.08, 95%CI 0.01-0.15) and in the highest concentration of serum cotinine (β = 0.10, 95%CI 0.01-0.19) compared to the group with the lowest serum cotinine concentrations. Current smokers, in comparison to non-smokers, exhibited a trend toward elevated sNfL levels (β = 0.07, 95%CI 0.01-0.13). Furthermore, subgroup analyses revealed interactions between serum cotinine levels and different age groups (P for interaction = 0.001) and gender stratification (P for interaction = 0.015) on sNfL levels. CONCLUSION The study suggested that serum cotinine was significantly and positively associated with sNfl levels in adult participants. Furthermore, current smokers tend to exhibit elevated sNfL levels. This research sheds light on the potential implications of smoke exposure on neurological function impairment and underscores the importance of further exploration in this area.
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Affiliation(s)
- Ning Zhu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University, 59 Liuting Road, 315010, Ningbo, Zhejiang, China
| | - Jing Zhu
- Department of Cardiology, The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, China
| | - Shanhong Lin
- Department of Ultrasound, The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Hang Yu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University, 59 Liuting Road, 315010, Ningbo, Zhejiang, China
| | - Chao Cao
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University, 59 Liuting Road, 315010, Ningbo, Zhejiang, China.
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4
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Parawira S, Reese V. Podcast on Identifying and Understanding Barriers to Care in Underserved Populations With MS in the United States. Neurol Ther 2024; 13:1-9. [PMID: 37982988 PMCID: PMC10787707 DOI: 10.1007/s40120-023-00559-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/16/2023] [Indexed: 11/21/2023] Open
Abstract
Multiple sclerosis (MS) can affect people from all racial and ethnic backgrounds, but, historically, the incidence of MS in the United States was thought to be highest in White individuals. More recent data suggest that the incidence of MS in Black or African American individuals is comparable to that in White individuals. In Hispanic or Latino individuals, incidence of MS is lower, but age of onset may be earlier compared with White individuals. Additionally, there are important differences in MS disease severity, disease progression, and mortality in Black or African American and Hispanic or Latino populations. Compared with their White counterparts, individuals from these underrepresented groups are more likely to be affected by MS in specific areas of the nervous system, such as accelerated loss of retinal and brain tissue in Black or African American individuals and optic neuritis in Hispanic individuals. Additionally, Black or African American individuals with MS tend to have an aggressive disease course, earlier disability, and higher risk of requiring ambulatory assistance. Although these differences may be attributed to genetic factors, systemic racism and biases and barriers to accessing care may perpetuate health disparities. Moreover, non-White communities remain broadly underrepresented in clinical trials; however, it is vital that these populations are appropriately represented so that any potential differences in drug efficacy or safety implications are detected. Thus, it is important to increase awareness of MS in these populations. In this podcast, the authors discuss characteristics of MS in Black or African American and Hispanic or Latino populations, identify barriers to care, and propose solutions to improve access to MS care in these populations. MP4 (358385 KB).
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Affiliation(s)
- Sandra Parawira
- Department of Neurology, University of Cincinnati, Waddell Center for Multiple Sclerosis, 3113 Bellevue Ave, Cincinnati, OH, 45219, USA.
| | - Victoria Reese
- We Are ILL, Patient Advocacy Organization, PO Box 36846, Los Angeles, CA, 90036, USA
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5
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Mahler JV, Solti M, Apóstolos-Pereira SL, Adoni T, Silva GD, Callegaro D. Vitamin D 3 as an add-on treatment for multiple sclerosis: A systematic review and meta-analysis of randomized controlled trials. Mult Scler Relat Disord 2024; 82:105433. [PMID: 38211504 DOI: 10.1016/j.msard.2024.105433] [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: 06/16/2023] [Revised: 12/28/2023] [Accepted: 01/05/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Vitamin D deficiency has been linked to a higher risk of multiple sclerosis (MS) and disease progression. However, the efficacy of vitamin D3 as an adjuvant therapy for MS remains a controversial topic. OBJECTIVE To perform a systematic review and meta-analysis of randomized controlled trials to assess the impact of adjunct high-dose vitamin D3 on clinical and radiological outcomes. METHODS PubMed, Embase, and Cochrane Library were searched for trials published until December 18th, 2022. Authors independently selected randomized controlled trials involving patients with MS, with an intervention group receiving high dose (≥ 1000 IU/day) cholecalciferol and reporting clinical or radiological outcomes. Authors independently extracted data and assessed the risk of bias using a standardized, pilot-tested form. The meta-analysis was conducted using RStudio for EDSS at the last follow-up, ARR, and new T2 lesion count. RESULTS We included 9 studies with 867 participants. No significant reduction of EDSS (MD = 0.02, CI 95 % [-0.37; 0.41], p = 0.91), ARR (MD -0.03, CI 95 % [-0.08; 0.02], p = 0.26), or new T2 lesions (MD -0.59, CI 95 % [-1.24;0.07], p = 0.08) was observed at 6-24 months. We found no evidence of publication bias. CONCLUSION The findings of this meta-analysis strengthen current evidence that vitamin D3 supplementation has no significant impact on clinical outcomes in patients with MS. However, the non-significant reduction of new T2 lesions could precede long-term clinical benefits and should be validated in additional studies.
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Affiliation(s)
| | - Marina Solti
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Tarso Adoni
- Neuroimmunology Group, Department of Neurology, Hospital of Clinics of the University of São Paulo, São Paulo, Brazil
| | - Guilherme Diogo Silva
- Neuroimmunology Group, Department of Neurology, Hospital of Clinics of the University of São Paulo, São Paulo, Brazil
| | - Dagoberto Callegaro
- Neuroimmunology Group, Department of Neurology, Hospital of Clinics of the University of São Paulo, São Paulo, Brazil
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6
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Shao BZ, Jiang JJ, Zhao YC, Zheng XR, Xi N, Zhao GR, Huang XW, Wang SL. Neutrophil extracellular traps in central nervous system (CNS) diseases. PeerJ 2024; 12:e16465. [PMID: 38188146 PMCID: PMC10771765 DOI: 10.7717/peerj.16465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/24/2023] [Indexed: 01/09/2024] Open
Abstract
Excessive induction of inflammatory and immune responses is widely considered as one of vital factors contributing to the pathogenesis and progression of central nervous system (CNS) diseases. Neutrophils are well-studied members of inflammatory and immune cell family, contributing to the innate and adaptive immunity. Neutrophil-released neutrophil extracellular traps (NETs) play an important role in the regulation of various kinds of diseases, including CNS diseases. In this review, current knowledge on the biological features of NETs will be introduced. In addition, the role of NETs in several popular and well-studied CNS diseases including cerebral stroke, Alzheimer's disease, multiple sclerosis, amyotrophic lateral sclerosis (ALS), and neurological cancers will be described and discussed through the reviewing of previous related studies.
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Affiliation(s)
- Bo-Zong Shao
- Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
| | | | - Yi-Cheng Zhao
- Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Rui Zheng
- Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
| | - Na Xi
- Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
| | - Guan-Ren Zhao
- Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Wu Huang
- Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
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7
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Schoeps VA, Cortese M, Munger KL, Mancuso JD, Niebuhr DW, Peng X, Ascherio A, Bjornevik K. Smoking and multiple sclerosis risk in black people: A nested case-control study. Mult Scler Relat Disord 2024; 81:105375. [PMID: 38104478 PMCID: PMC10843624 DOI: 10.1016/j.msard.2023.105375] [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: 08/25/2023] [Revised: 11/21/2023] [Accepted: 12/10/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Smoking is a well-established risk factor for MS; however, it is not known whether its effect on disease risk varies by race/ethnicity. METHODS We conducted a nested case-control study among US military personnel who have serum samples stored at the Department of Defense Serum Repository. We measured serum cotinine levels, a marker of tobacco smoke exposure, in 157 Black and 23 White individuals who developed MS during follow-up. Controls were randomly selected and matched to each case by age, sex, race/ethnicity, dates of sample collection, and branch of military service. RESULTS Smoking was not associated with an increased risk of MS in Black people (RR: 1.08, 95 % CI: 0.63-1.85). The results remained similar in analyses restricted to smoking status at baseline, to samples collected 5 years before symptom onset, and using different cut-off levels in cotinine to define smoking status. Smoking was not statistically significantly associated with MS risk in White people, but the point estimate was similar to what has previously been reported in other studies (RR: 1.85, 95 % CI: 0.56-6.16). CONCLUSIONS Smoking was not associated with MS risk in Black people. Given the consistent association between smoking and MS risk in predominantly White populations, this may suggest that the association between smoking and MS varies by race/ethnicity.
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Affiliation(s)
- Vinicius A Schoeps
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
| | - Marianna Cortese
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Kassandra L Munger
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - James D Mancuso
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - David W Niebuhr
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Xiaojing Peng
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Alberto Ascherio
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kjetil Bjornevik
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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8
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Zierfuss B, Larochelle C, Prat A. Blood-brain barrier dysfunction in multiple sclerosis: causes, consequences, and potential effects of therapies. Lancet Neurol 2024; 23:95-109. [PMID: 38101906 DOI: 10.1016/s1474-4422(23)00377-0] [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: 02/06/2023] [Revised: 08/14/2023] [Accepted: 09/28/2023] [Indexed: 12/17/2023]
Abstract
Established by brain endothelial cells, the blood-brain barrier (BBB) regulates the trafficking of molecules, restricts immune cell entry into the CNS, and has an active role in neurovascular coupling (the regulation of cerebral blood flow to support neuronal activity). In the early stages of multiple sclerosis, around the time of symptom onset, inflammatory BBB damage is accompanied by pathogenic immune cell infiltration into the CNS. In the later stages of multiple sclerosis, dysregulation of neurovascular coupling is associated with grey matter atrophy. Genetic and environmental factors associated with multiple sclerosis, including dietary habits, the gut microbiome, and vitamin D concentrations, might contribute directly and indirectly to brain endothelial cell dysfunction. Damage to brain endothelial cells leads to an influx of deleterious molecules into the CNS, accelerating leakage across the BBB. Potential future therapeutic approaches might help to prevent BBB damage (eg, monoclonal antibodies targeting cell adhesion molecules and fibrinogen) and help to repair BBB dysfunction (eg, mesenchymal stromal cells) in people with multiple sclerosis.
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Affiliation(s)
- Bettina Zierfuss
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC H2X 0A9, Canada; Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Catherine Larochelle
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC H2X 0A9, Canada; Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada; Multiple Sclerosis Clinic, Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Alexandre Prat
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC H2X 0A9, Canada; Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada; Multiple Sclerosis Clinic, Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada.
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9
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Gao T, Hou M, Wang Q, Liu D, Chen F, Xing Y, Mei J. The roles of serum vitamin D and tobacco smoke exposure in insomnia: a cross-sectional study of adults in the United States. Front Nutr 2023; 10:1285494. [PMID: 38170097 PMCID: PMC10759233 DOI: 10.3389/fnut.2023.1285494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/23/2023] [Indexed: 01/05/2024] Open
Abstract
Aim Tobacco smoke exposure and vitamin D (VD) status were both associated with insomnia. However, the combined effect of smoking and VD on insomnia has not been discussed. This study aimed to explore the role of VD in the association between tobacco smoke exposure and insomnia. Methods Data on adults were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2005-2008 for this cross-sectional study. Weighted univariate and multivariate logistic regression analyses were used to explore the associations between serum cotinine, serum VD, and insomnia. A surface diagram was drawn to reflect the effect of VD on the association between serum cotinine and insomnia. In addition, the potential regulating effect of VD in subgroups of smoking status was also performed. The evaluation index was odds ratios (ORs) with 95% confidence intervals (CIs). Results Among the eligible participants, 1,766 had insomnia. After adjusting for covariates, we found that elevated serum cotinine levels were associated with higher odds of insomnia [OR = 1.55, 95% CI: (1.22, 1.97)]. However, the relationship between serum VD level and insomnia was not significant (P = 0.553). Higher serum cotinine levels were also associated with higher odds of insomnia [OR = 1.52, 95% CI: (1.17, 1.98)] when serum VD level was <75 nmol/L; however, this relationship became non-significant when serum VD concentration was elevated (P = 0.088). Additionally, the potential regulating effect of VD was also found in adults who were not smoking. Conclusion VD may play a potential regulative role in the association between tobacco smoke exposure and insomnia. Further studies are needed to clarify the causal relationships between VD, tobacco smoke exposure, and insomnia.
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Affiliation(s)
- Tianci Gao
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Department of Emergency, First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Mengxing Hou
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Department of Emergency, First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Qianfei Wang
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Department of Emergency, First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Dong Liu
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Department of Traditional Chinese Medicine, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Fenqiao Chen
- Department of Emergency, First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Yueyi Xing
- School of Basic Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Jianqiang Mei
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Department of Emergency, First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
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Spiezia AL, Falco F, Manganelli A, Carotenuto A, Petracca M, Novarella F, Iacovazzo C, Servillo G, Lanzillo R, Brescia Morra V, Moccia M. Low serum 25‑hydroxy-vitamin D levels are associated with cognitive impairment in multiple sclerosis. Mult Scler Relat Disord 2023; 79:105044. [PMID: 37837668 DOI: 10.1016/j.msard.2023.105044] [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: 05/29/2023] [Revised: 09/22/2023] [Accepted: 09/29/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Cognitive impairment frequently affects people with multiple sclerosis (MS). Low vitamin D has been associated with cognitive dysfunction in different neurodegenerative diseases, and, in MS, with motor disability and disease activity. We aim to investigate associations between vitamin D and cognitive status in MS. METHODS In this cross-sectional study, we included 181 MS patients, recruited consecutively at the MS Unit of the Policlinico Federico II University Hospital of Naples, Italy, between January and April 2022, with serum 25‑hydroxy (25-OH) vitamin D measurements using Chemiluminescence-ImmunoAssay, and cognitive assessment using the Brief International Cognitive Assessment for MS (BICAMS), which includes Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT-II) and Brief Visuospatial Memory Test-Revised (BVMT-R). We collected demographics (age, sex, education), and clinical variables (disease duration, disease subtype, expanded disability status scale (EDSS), disease modifying treatment, relapses in previous 12 months, vitamin D supplementation, comorbidities). For a subset of patients (n = 41, 23.2% of the total sample), we collected Beck Depression Inventory-II, Beck Anxiety Inventory, and Modified Fatigue Impact Scale. RESULTS At univariable linear regression models, serum 25-OH-vitamin D levels were 0.9 ng/mL higher for each unit increase of SDMT adjusted scores (Coeff=0.93; 95%CI=0.81, 1.04; p<0.01), 0.7 ng/mL higher for each unit increase of CVLT-II adjusted scores (Coeff=0.68; 95%CI=0.53, 0.83; p<0. 01), 0.6 ng/mL higher for each unit increase of BVMT-R adjusted scores (Coeff=0.58; 95%CI=0.43, 0.73; p<0.01), -9.63 ng/mL lower for each impaired BICAMS test (Coeff=-9.63; 95%CI=-11.48, -7.79; p<0.01), and -2.2 ng/mL lower for each unit increase of EDSS (Coeff=-2.16; 95%CI=-3.57, -0.75; p<0.01). At multivariable linear regression models, we confirmed associations between 25-OH-vitamin D and EDSS (Coeff=-2.09; 95%CI=-4.45, -0.43; p<0.01), SDMT (Coeff=0.75; 95%CI=0.60, 0.90; p<0.01), and CVLT-II (Coeff=0.14; 95%CI=0.01, 0.28; p = 0. 04). Results remained unchanged when including depression, anxiety and fatigue scores. CONCLUSIONS Lower serum 25-OH-vitamin D was associated with worse cognitive function in MS. Future studies should consider longitudinal variations in cognitive function in relation to vitamin D supplementation.
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Affiliation(s)
- Antonio Luca Spiezia
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Fabrizia Falco
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Andrea Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Antonio Carotenuto
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Maria Petracca
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Federica Novarella
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Carmine Iacovazzo
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Giuseppe Servillo
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Roberta Lanzillo
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy; Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Naples, Italy
| | - Vincenzo Brescia Morra
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy; Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Naples, Italy
| | - Marcello Moccia
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Naples, Italy; Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Naples, Italy.
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Wang Y, Wang J, Feng J. Multiple sclerosis and pregnancy: Pathogenesis, influencing factors, and treatment options. Autoimmun Rev 2023; 22:103449. [PMID: 37741528 DOI: 10.1016/j.autrev.2023.103449] [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: 08/27/2023] [Accepted: 09/18/2023] [Indexed: 09/25/2023]
Abstract
Multiple sclerosis (MS) is an autoimmune-mediated degenerative disease of the central nervous system, characterized by inflammatory demyelination. It is primarily found in women of childbearing age, making pregnancy a significant concern for both patients with MS and clinicians. To assist these patients in achieving their desire for pregnancy, reducing MS relapses during all stages of pregnancy, preventing the progression of MS, mitigating the impact of MS treatment on the course and outcome of pregnancy, and a thorough understanding of the relationship between pregnancy and MS, as well as specific management and the application of relevant medications for MS patients at each stage of pregnancy, are essential. This article provides an update on pregnancy-related issues in women with MS, including the general recommendations for management at each stage of pregnancy.
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Affiliation(s)
- Yinxiang Wang
- Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao St., Shenyang 110004, China
| | - Jue Wang
- Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao St., Shenyang 110004, China
| | - Juan Feng
- Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao St., Shenyang 110004, China.
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Krause N, Derad C, von Glasenapp B, Riemann-Lorenz K, Temmes H, van de Loo M, Friede T, Asendorf T, Heesen C. Association of health behaviour and clinical manifestation in early multiple sclerosis in Germany - Baseline characteristics of the POWER@MS1 randomised controlled trial. Mult Scler Relat Disord 2023; 79:105043. [PMID: 37839367 DOI: 10.1016/j.msard.2023.105043] [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: 04/18/2023] [Revised: 09/04/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Receiving a multiple sclerosis (MS) diagnosis is a significant stressor. Therefore, highly individualised counselling is needed, especially in early MS. Modifiable risk factors (e.g. smoking and obesity) are gaining relevance in MS. Despite evidence for worse MS-related health outcomes, prevalence of adverse health behaviours, such as smoking and physical inactivity, is high across all MS stages. However, knowledge regarding health behaviours as well as their association with MS-related health outcomes among newly diagnosed PwMS in Germany is scarce. Currently, the efficacy of an interactive digital lifestyle management application intended to be used as an add-on to standard care among newly diagnosed PwMS in Germany is evaluated in an ongoing multicentre randomised controlled trial (RCT) ('POWER@MS1'). OBJECTIVES To describe baseline disease characteristics and health behaviours of the POWER@MS1 cohort and investigate associations between MS characteristics, quality of life (QOL), health behaviours and intention to optimise health behaviour habits. METHODS This study included 234 persons with early MS from 20 study centres located across Germany who participate in the POWER@MS1 RCT. Participants were recruited by treating neurologists from different regions and health-care settings in Germany. Baseline data was obtained using paper-based questionnaires and a web-based healthy diet screener between July 2019 and end of March 2022 and analysed descriptively. RESULTS In this early MS cohort (mean disease duration 4 months), a screening tool showed severe symptoms of anxiety in 15 % of the participants. Better means for stress management appeared to be particularly relevant for the whole cohort. Moreover, 19 % were current smokers, 15 % were obese and 36 % were insufficiently physically active. On average, participants only moderately adhered to dietary guidelines for recommended intake of key food groups (e.g. vegetables, fruits and fatty marine fish). Higher EDSS scores were associated with approximately 20 % higher T2-lesion burden (rate ratio RR=1.2, p<0.001) and 13 % higher relapse rate (RR=1.13,p=0.02) per EDSS disability level. Moreover, a higher T2-lesion burden was associated with current smoking (RR=0.76, p=0.033), resulting in approximately 24 % less T2-lesions at disease onset among non-smokers. In addition, smoking was associated with unhealthier dietary habits according to lower diet scores (linear regression coefficient β=-1.27, p<0.001). Higher EDSS scores (β=0.19,p<0.001) and higher BMI (β=0.013,p=0.03) were associated with higher HAQUAMS (lower QOL). Further, lower diet scores (β=-0.044,p=0.039) were associated with lower QOL. Moreover, higher HAQUAMS (lower QOL) indicated a higher intention to optimise stress management (β=0.98,p<0.001), physical activity (β=0.74,p=0.046) and sleep behaviour (β=1.82,p<0.001). Further, higher intention to optimise stress management was accounted for by higher EDSS scores (β=0.39,p=0.004) and a higher number of T2-lesions (β=0.029,p=0.015) in this newly diagnosed MS cohort. CONCLUSION Results indicate a clear need for modifications of health behaviours among newly diagnosed PwMS participating in POWER@MS1. Individualised psychological and health behaviour counselling appears to be an important factor in treatment, also for similar early MS cohorts and particularly in those who demonstrate a more severe disease in clinical and MRI metrics.
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Affiliation(s)
- Nicole Krause
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg 20246, Germany.
| | - Carlotta Derad
- Department of Medical Statistics, University Medical Centre Göttingen, Göttingen, Germany
| | - Barbara von Glasenapp
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg 20246, Germany
| | - Karin Riemann-Lorenz
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg 20246, Germany
| | - Herbert Temmes
- German Multiple Sclerosis Society, Federal Association, Hannover, Germany
| | - Markus van de Loo
- German Multiple Sclerosis Society, Federal Association, Hannover, Germany
| | - Tim Friede
- Department of Medical Statistics, University Medical Centre Göttingen, Göttingen, Germany
| | - Thomas Asendorf
- Department of Medical Statistics, University Medical Centre Göttingen, Göttingen, Germany
| | - Christoph Heesen
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg 20246, Germany
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Gu Z, Sun X, Wu C, Li B, Chen J, Wang W, Gao X, Tan Y, Li B, Yin G, Xu Y, Song C, Du B, Bi X. Lower 25-hydroxyvitamin D is associated with severer white matter hyperintensity and cognitive function in patients with non-disabling ischemic cerebrovascular events. J Stroke Cerebrovasc Dis 2023; 32:107311. [PMID: 37659193 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107311] [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: 05/18/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/04/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the potential correlations among serum 25-hydroxyvitamin D [25(OH)D] levels, white matter hyperintensity (WMH) and cognitive function in patients with non-disabling ischemic cerebrovascular events (NICE). METHODS This was a prospective investigation of 160 NICE patients with age of 40 years or older. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA). White matter lesions were evaluated by WMH using Fazekas scores. Spearman correlation analysis and linear regression models were used to identify the associations between serum 25(OH)D levels and cognitive function. Binary logistic regression analysis models were used to evaluate the predictable value of serum 25(OH)D levels and WMH for cognitive impairment. RESULTS Patients with inadequate 25(OH)D levels had lower MoCA score (P=0.008), and a higher proportion of severe WMH (P=0.043). Spearman correlation analysis demonstrated that serum 25(OH)D concentrations were positively associated with MoCA score (rs=0.185, P=0.019) while negatively related to the proportion of severe WMH (sWMH) (rs=-0.166, P=0.036).The association between 25(OH)D concentrations and MoCA score remained significant in linear regression (adjusted β=0.012, 95%CI:0.001-0.203).Adjusted binary logistic regression analysis showed that the odds ratio of cognitive impairment with insufficient 25(OH)D concentration was 5.038 (95%CI:1.154-21.988) compared with the sufficient group and the sWMH (OR=2.728, 95%CI:1.230-6.051) was identified as an independent risk factor for cognitive decline in NICE patients. CONCLUSION Serum 25(OH)D levels and white matter lesions were independently and significantly associated with cognitive impairment in NICE patients.
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Affiliation(s)
- Zhengsheng Gu
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xu Sun
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Chenghao Wu
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Binghan Li
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Jingjing Chen
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Weisen Wang
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xin Gao
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yuhao Tan
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Bin Li
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Ge Yin
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yawen Xu
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Chenrui Song
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Bingying Du
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China.
| | - Xiaoying Bi
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China.
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Jakimovski D, Weinstock-Guttman B, Zivadinov R. Ublituximab-xiiy as a treatment option for relapsing multiple sclerosis. Expert Rev Neurother 2023; 23:1053-1061. [PMID: 37842819 DOI: 10.1080/14737175.2023.2268842] [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: 06/20/2023] [Accepted: 10/05/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION B cell depletion has been established as an efficacious anti-inflammatory therapy in people with relapsing forms of multiple sclerosis (MS). Ublituximab (ublituximab-xiiy) is the latest approved chimeric glycoengineered anti-CD20 monoclonal antibody (mAb) for the treatment of relapsing forms of MS. AREAS COVERED In this narrative review, the authors explore the safety and effectiveness of data derived from the Phase 2 and Phase 3 ublituximab trials and from their respective post-hoc analyses. Moreover, they consider the similarities and differences between the currently available anti-CD20 antibodies for treatment of relapsing MS. Lastly, the authors discuss the role and place of ublituximab in the current disease modifying therapy landscape. EXPERT OPINION Ublituximab is a rapid-acting and effective anti-inflammatory option as a treatment in people with relapsing MS that significantly reduced the annualized relapse rate and MRI-based disease activity. When compared to the Phase III trials of the other two anti-CD20 mAbs (ocrelizumab and ofatumumab), ublituximab did not result with reduction of 3 or 6-month confirmed disability progression. These differences may be attributed to the overall low rate of progression in both the ublituximab and the active comparator teriflunomide arm. Future data from open-label extensions are warranted. There was no significant reduction of ublituximab on whole-brain atrophy compared to teriflunomide.
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Affiliation(s)
- Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
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15
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Montini F, Nozzolillo A, Rancoita PMV, Zanetta C, Moiola L, Cugnata F, Esposito F, Rocca MA, Martinelli V, Filippi M. Modifiable risk factors of COVID-19 in patients with multiple sclerosis: a single-centre case-control study. J Neurol 2023; 270:1835-1842. [PMID: 36795147 PMCID: PMC9933018 DOI: 10.1007/s00415-023-11618-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Disease and treatment-associated immune system abnormalities may confer higher risk of Coronavirus disease 2019 (COVID-19) to people with multiple sclerosis (PwMS). We assessed modifiable risk factors associated with COVID-19 in PwMS. METHODS Among patients referring to our MS Center, we retrospectively collected epidemiological, clinical and laboratory data of PwMS with confirmed COVID-19 between March 2020 and March 2021 (MS-COVID, n = 149). We pursued a 1:2 matching of a control group by collecting data of PwMS without history of previous COVID-19 (MS-NCOVID, n = 292). MS-COVID and MS-NCOVID were matched for age, expanded disability status scale (EDSS) and line of treatment. We compared neurological examination, premorbid vitamin D levels, anthropometric variables, life-style habits, working activity, and living environment between the two groups. Logistic regression and Bayesian network analyses were used to evaluate the association with COVID-19. RESULTS MS-COVID and MS-NCOVID were similar in terms of age, sex, disease duration, EDSS, clinical phenotype and treatment. At multiple logistic regression, higher levels of vitamin D (OR 0.93, p < 0.0001) and active smoking status (OR 0.27, p < 0.0001) emerged as protective factors against COVID-19. In contrast, higher number of cohabitants (OR 1.26, p = 0.02) and works requiring direct external contact (OR 2.61, p = 0.0002) or in the healthcare sector (OR 3.73, p = 0.0019) resulted risk factors for COVID-19. Bayesian network analysis showed that patients working in the healthcare sector, and therefore exposed to increased risk of COVID-19, were usually non-smokers, possibly explaining the protective association between active smoking and COVID-19. CONCLUSIONS Higher Vitamin D levels and teleworking may prevent unnecessary risk of infection in PwMS.
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Affiliation(s)
- Federico Montini
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Agostino Nozzolillo
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Paola M V Rancoita
- University Centre for Statistics in the Biomedical Sciences (CUSSB), Vita-Salute San Raffaele University, Milan, Italy
| | - Chiara Zanetta
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Lucia Moiola
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Federica Cugnata
- University Centre for Statistics in the Biomedical Sciences (CUSSB), Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Esposito
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Maria A Rocca
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Vittorio Martinelli
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Massimo Filippi
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Vita-Salute San Raffaele University, Milan, Italy.
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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16
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Rademacher TD, Meuth SG, Wiendl H, Johnen A, Landmeyer NC. Molecular biomarkers and cognitive impairment in multiple sclerosis: State of the field, limitations, and future direction - A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 146:105035. [PMID: 36608917 DOI: 10.1016/j.neubiorev.2023.105035] [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: 10/12/2022] [Revised: 12/20/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Multiple sclerosis (MS) is associated with cognitive impairment (CI) such as slowed information processing speed (IPS). Currently, no immunocellular or molecular markers have been established in cerebrospinal fluid and serum analysis as surrogate biomarkers with diagnostic or predictive value for the development of CI. This systematic review and meta-analysis aims to sum up the evidence regarding currently discussed markers for CI in MS. METHODS A literature search was conducted on molecular biomarkers of CI in MS, such as neurofilament light chain, chitinases, and vitamin D. RESULTS 5543 publications were screened, of which 77 entered the systematic review. 13 studies were included in the meta-analysis. Neurofilament light chain (CSF: rp = -0.294, p = 0.003; serum: rp = -0.137, p = 0.001) and serum levels of vitamin D (rp = 0.190, p = 0.014) were associated with IPS outcomes. CONCLUSIONS Neurofilament light chain and vitamin D are promising biomarkers to track impairments in IPS in MS. Further longitudinal research is needed to establish the use of molecular biomarkers to monitor cognitive decline.
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Affiliation(s)
| | - Sven G Meuth
- Department of Neurology, University Hospital Düsseldorf, Germany
| | - Heinz Wiendl
- Department of Neurology, University Hospital Münster, Germany
| | - Andreas Johnen
- Department of Neurology, University Hospital Münster, Germany
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17
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Li S, Xu X, Qiu Y, Teng Z, Liu J, Yuan H, Chen J, Tan Y, Yang M, Jin K, Xu B, Tang H, Zhao Z, Wang B, Xiang H, Wu H. Alternations of vitamin D and cognitive function in first-diagnosed and drug-naïve BD patients: Physical activity as a moderator. J Affect Disord 2023; 323:153-161. [PMID: 36436763 DOI: 10.1016/j.jad.2022.11.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 11/13/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The pathophysiological mechanism of cognitive impairments of bipolar disorder (BD) has not yet been completely revealed. It is well known that Vitamin D and physical activity (PA) are associated with BD. However, specific links between Vitamin D and cognitive deficits in BD are still unclear. METHOD The serum levels of vitamin D were measured. The cognitive performances of 102 first-diagnosed and drug-naïve BD patients were evaluated for analysis. The repeatable battery for the assessment of neuropsychological status (RBANS) and the Stroop Color-Word test was used in this study. PA was collected by international physical activity questionnaire. RESULT Patients with BD had high levels of serum vitamin D. Furthermore, immediate and delayed memory was negatively associated with vitamin D levels in patients' group. The serum levels of vitamin D in patients with low PA were positively associated with memory. However, increased PA attenuated the protective effect of vitamin D on executive cognition. CONCLUSION It is concluded that the increased levels of vitamin D were observed in the serum of patients with BD. Thus, it is found that more PA is less beneficial to cognition of patients with BD than longer resting.
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Affiliation(s)
- Sujuan Li
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xuelei Xu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yan Qiu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Ziwei Teng
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jieyu Liu
- Department of Ultrasound Diagnostic, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Yuan
- Department of Stomatology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yuxi Tan
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Min Yang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Kun Jin
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Baoyan Xu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Hebei Provincial Mental Health Center, No.572 Dongfeng East RD., Baoding City 071000, Hebei Province, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Tang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Ziru Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Bolun Wang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Xiang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Haishan Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Abu-Rumeileh S, Abdelhak A, Foschi M, D'Anna L, Russo M, Steinacker P, Kuhle J, Tumani H, Blennow K, Otto M. The multifaceted role of neurofilament light chain protein in non-primary neurological diseases. Brain 2023; 146:421-437. [PMID: 36083979 PMCID: PMC9494370 DOI: 10.1093/brain/awac328] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 09/02/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
The advancing validation and exploitation of CSF and blood neurofilament light chain protein as a biomarker of neuroaxonal damage has deeply changed the current diagnostic and prognostic approach to neurological diseases. Further, recent studies have provided evidence of potential new applications of this biomarker also in non-primary neurological diseases. In the present review we summarize the state of the art, future perspectives, but also limitations, of neurofilament light chain protein as a CSF and blood biomarker in several medical fields, including intensive care medicine, surgery, internal medicine and psychiatry. In particular, neurofilament light chain protein is associated with the degree of neurological impairment and outcome in patients admitted to intensive care units or in the perioperative phase and it seems to be highly interconnected with cardiovascular risk factors. Beyond that, interesting diagnostic and prognostic insights have been provided by the investigation of neurofilament light chain protein in psychiatric disorders as well as in the current coronavirus disease-19 pandemic and in normal ageing. Altogether, current data outline a multifaceted applicability of CSF and blood neurofilament light chain protein ranging from the critical clinical setting to the development of precision medicine models suggesting a strict interplay between the nervous system pathophysiology and the health-illness continuum.
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Affiliation(s)
- Samir Abu-Rumeileh
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany
| | - Ahmed Abdelhak
- Department of Neurology, University of California San Francisco (UCSF), San Francisco, USA
- Department of Neurology, Ulm University Hospital, Ulm, Germany
| | - Matteo Foschi
- Department of Neuroscience, Neurology Unit – S. Maria delle Croci Hospital of Ravenna, AUSL Romagna, Ravenna, Italy
| | - Lucio D'Anna
- Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College London, NHS Healthcare Trust, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Michele Russo
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Petra Steinacker
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany
| | - Jens Kuhle
- Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Markus Otto
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany
- Department of Neurology, Ulm University Hospital, Ulm, Germany
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19
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Dickerson F, Katsafanas E, Origoni A, Newman T, Rowe K, Ziemann RS, Bhatia K, Severance E, Ford G, Yolken R. Cigarette smoking is associated with Herpesviruses in persons with and without serious mental illness. PLoS One 2023; 18:e0280443. [PMID: 36652488 PMCID: PMC9847975 DOI: 10.1371/journal.pone.0280443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/31/2022] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Herpesviruses are recognized as major causes of human diseases. Following initial infection, Herpesviruses can undergo cycles of reactivation controlled largely by the immune system. Cigarette smoking is an important modulator of the immune system particularly in individuals with serious mental illness where smoking is associated with increased rates of cardiopulmonary diseases and mortality. However, the effect of smoking on Herpesviruses has not been extensively studied. METHODS In this nested cohort study, cigarette smoking was assessed in 1323 persons with serious mental illness or without a psychiatric disorder ascertained in a psychiatric health care system and the adjacent community. Participants provided a blood sample from which were measured IgG class antibodies to five human Herpesviruses: Cytomegalovirus (CMV), Epstein Barr Virus (EBV), Herpes Simplex Virus-Type 1 (HSV-1); Varicella Zoster Virus (VZV); and Human Herpes Virus-Type 6 (HHV-6). The associations between smoking variables and antibody levels to the Herpesviruses were analyzed among diagnostic groups in multiple regression models adjusted for age, sex, and race. RESULTS Current smoking was significantly associated with higher levels of antibodies to CMV (coefficient .183, 95% CI .049, .317, p<.001, q<.007) and the three EBV proteins (EBV NA -(coefficient .088, 95% CI .032, .143, p = .002, q<.014; EBV Virion - coefficient .100, 95% CI .037, .163, p = .002, q<.014; and EBV VCA - coefficient .119, 95% CI .061, .177, p = .00004, q<.0016). The amount of cigarettes smoked was also correlated with higher levels of antibodies to the three EBV proteins. Interaction analyses indicated that the association between cigarette smoking and levels of antibodies to CMV and EBV was independent of diagnostic group. Cigarette smoking was not significantly associated with the level of antibodies to HSV-1, VZV, or HHV-6. CONCLUSIONS Individuals who smoke cigarettes have increased levels of IgG antibodies to CMV and EBV. Cigarette smoking may be a contributory factor in the relationship between CMV, EBV and chronic somatic disorders associated with these viruses.
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Affiliation(s)
- Faith Dickerson
- The Stanley Research Program at Sheppard Pratt, Baltimore, Maryland, United States of America
- * E-mail:
| | - Emily Katsafanas
- The Stanley Research Program at Sheppard Pratt, Baltimore, Maryland, United States of America
| | - Andrea Origoni
- The Stanley Research Program at Sheppard Pratt, Baltimore, Maryland, United States of America
| | - Theresa Newman
- The Stanley Research Program at Sheppard Pratt, Baltimore, Maryland, United States of America
| | - Kelly Rowe
- The Stanley Research Program at Sheppard Pratt, Baltimore, Maryland, United States of America
| | - Rita S. Ziemann
- The Stanley Research Program at Sheppard Pratt, Baltimore, Maryland, United States of America
| | - Kamal Bhatia
- The Stanley Research Program at Sheppard Pratt, Baltimore, Maryland, United States of America
| | - Emily Severance
- The Stanley Neurovirology Laboratory, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Glen Ford
- VanPelt Biosciences, Rockville, Maryland, United States of America
| | - Robert Yolken
- The Stanley Neurovirology Laboratory, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
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20
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Orton SM, Sangha A, Gupta M, Martens K, Metz LM, de Koning APJ, Pfeffer G. Expression of risk genes linked to vitamin D receptor super-enhancer regions and their association with phenotype severity in multiple sclerosis. Front Neurol 2022; 13:1064008. [PMID: 36644209 PMCID: PMC9832371 DOI: 10.3389/fneur.2022.1064008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/05/2022] [Indexed: 12/29/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic debilitating neurological condition with a wide range of phenotype variability. A complex interplay of genetic and environmental factors contributes to disease onset and progression in MS patients. Vitamin D deficiency is a known susceptibility factor for MS, however the underlying mechanism of vitamin D-gene interactions in MS etiology is still poorly understood. Vitamin D receptor super-enhancers (VSEs) are enriched in MS risk variants and may modulate these environment-gene interactions. mRNA expression in total of 64 patients with contrasting MS severity was quantified in select genes. First, RNA-seq was performed on a discovery cohort (10 mild, 10 severe MS phenotype) and ten genes regulated by VSEs that have been linked to MS risk were analyzed. Four candidates showed a significant positive association (GRINA, PLEC, PARP10, and LRG1) in the discovery cohort and were then quantified using digital droplet PCR (ddPCR) in a validation cohort (33 mild, 11 severe MS phenotype). A significant differential expression persisted in the validation cohort for three of the VSE-MS genes: GRINA (p = 0.0138), LRG1 (p = 0.0157), and PLEC (p = 0.0391). In summary, genes regulated by VSE regions that contain known MS risk variants were shown to have differential expression based on disease severity (p<0.05). The findings implicate a role for vitamin D super-enhancers in modulating disease activity. In addition, expression levels may have some utility as prognostic biomarkers in the future.
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Affiliation(s)
- Sarah M. Orton
- Faculty of Science and Technology, Mount Royal University, Calgary, AB, Canada,*Correspondence: Sarah M. Orton ✉
| | - Amarpreet Sangha
- Faculty of Science and Technology, Mount Royal University, Calgary, AB, Canada
| | - Mehul Gupta
- Department of Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Kristina Martens
- Department of Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Luanne M. Metz
- Department of Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - A. P. J. de Koning
- Department of Medical Genetics, Alberta Child Health Research Institute, Cumming of Medicine, University of Calgary, Calgary, AB, Canada
| | - Gerald Pfeffer
- Department of Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada,Department of Medical Genetics, Alberta Child Health Research Institute, Cumming of Medicine, University of Calgary, Calgary, AB, Canada
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21
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Wieland L, Schwarz T, Engel K, Volkmer I, Krüger A, Tarabuko A, Junghans J, Kornhuber ME, Hoffmann F, Staege MS, Emmer A. Epstein-Barr Virus-Induced Genes and Endogenous Retroviruses in Immortalized B Cells from Patients with Multiple Sclerosis. Cells 2022; 11:cells11223619. [PMID: 36429047 PMCID: PMC9688211 DOI: 10.3390/cells11223619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/28/2022] [Accepted: 11/06/2022] [Indexed: 11/18/2022] Open
Abstract
The immune pathogenesis of multiple sclerosis (MS) is thought to be triggered by environmental factors in individuals with an unfavorable genetic predisposition. Epstein-Barr virus (EBV) infection is a major risk factor for subsequent development of MS. Human endogenous retroviruses (HERVs) can be activated by EBV, and might be a missing link between an initial EBV infection and the later onset of MS. In this study, we investigated differential gene expression patterns in EBV-immortalized lymphoblastoid B cell lines (LCL) from MS-affected individuals (MSLCL) and controls by using RNAseq and qRT-PCR. RNAseq data from LCL mapped to the human genome and a virtual virus metagenome were used to identify possible biomarkers for MS or disease-relevant risk factors, e.g., the relapse rate. We observed that lytic EBNA-1 transcripts seemed to be negatively correlated with age leading to an increased expression in LCL from younger PBMC donors. Further, HERV-K (HML-2) GAG was increased upon EBV-triggered immortalization. Besides the well-known transactivation of HERV-K18, our results suggest that another six HERV loci are up-regulated upon stimulation with EBV. We identified differentially expressed genes in MSLCL, e.g., several HERV-K loci, ERVMER61-1 and ERV3-1, as well as genes associated with relapses. In summary, EBV induces genes and HERV in LCL that might be suitable as biomarkers for MS or the relapse risk.
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Affiliation(s)
- Lisa Wieland
- Department of Neurology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Tommy Schwarz
- Department of Neurology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Kristina Engel
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Ines Volkmer
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Anna Krüger
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Alexander Tarabuko
- Department of Neurology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Jutta Junghans
- Department of Neurology, Martha-Maria Hospital Halle-Dölau, 06120 Halle (Saale), Germany
| | - Malte E. Kornhuber
- Department of Neurology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Frank Hoffmann
- Department of Neurology, Martha-Maria Hospital Halle-Dölau, 06120 Halle (Saale), Germany
| | - Martin S. Staege
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
- Correspondence: ; Tel.: +49-34-5557-7280
| | - Alexander Emmer
- Department of Neurology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
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22
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Lifestyle factors in multiple sclerosis disability progression and silent brain damage: A cross-sectional study. Mult Scler Relat Disord 2022; 65:104016. [DOI: 10.1016/j.msard.2022.104016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/02/2022] [Accepted: 07/01/2022] [Indexed: 11/17/2022]
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23
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Lie IA, Wesnes K, Kvistad SS, Brouwer I, Wergeland S, Holmøy T, Midgard R, Bru A, Edland A, Eikeland R, Gosal S, Harbo HF, Kleveland G, Sørenes YS, Øksendal N, Barkhof F, Vrenken H, Myhr KM, Bø L, Torkildsen Ø. The Effect of Smoking on Long-term Gray Matter Atrophy and Clinical Disability in Patients with Relapsing-Remitting Multiple Sclerosis. NEUROLOGY - NEUROIMMUNOLOGY NEUROINFLAMMATION 2022; 9:9/5/e200008. [PMID: 35738901 PMCID: PMC9223432 DOI: 10.1212/nxi.0000000000200008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/06/2022] [Indexed: 11/15/2022]
Abstract
Background and Objectives The relationship between smoking, long-term brain atrophy, and clinical disability in patients with multiple sclerosis (MS) is unclear. Here, we assessed long-term effects of smoking by evaluating MRI and clinical outcome measures after 10 years in smoking and nonsmoking patients with relapsing-remitting MS (RRMS). Methods We included 85 treatment-naive patients with RRMS with recent inflammatory disease activity who participated in a 10-year follow-up visit after a multicenter clinical trial of 24 months. Smoking status was decided for each patient by 2 separate definitions: by serum cotinine levels measured regularly for the first 2 years of the follow-up (during the clinical trial) and by retrospective patient self-reporting. At the 10-year follow-up visit, clinical tests were repeated, and brain atrophy measures were obtained from MRI using FreeSurfer. Differences in clinical and MRI measurements at the 10-year follow-up between smokers and nonsmokers were investigated by 2-sample t tests or Mann-Whitney tests and linear mixed-effect regression models. All analyses were conducted separately for each definition of smoking status. Results After 10 years, smoking (defined by serum cotinine levels) was associated with lower total white matter volume (β = −21.74, p = 0.039) and higher logT2 lesion volume (β = 0.22, p = 0.011). When defining smoking status by patient self-reporting, the repeated analyses found an additional association with lower deep gray matter volume (β = −2.35, p = 0.049), and smoking was also associated with a higher score (higher walking impairment) on the log timed 25-foot walk test (β = 0.050, p = 0.039) after 10 years and a larger decrease in paced auditory serial addition test (attention) scores (β = −3.58, p = 0.029). Discussion Smoking was associated with brain atrophy and disability progression 10 years later in patients with RRMS. The findings imply that patients should be advised and offered aid in smoking cessation shortly after diagnosis, to prevent long-term disability progression.
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Affiliation(s)
- Ingrid Anne Lie
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway.
| | - Kristin Wesnes
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Silje S Kvistad
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Iman Brouwer
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Stig Wergeland
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Trygve Holmøy
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Rune Midgard
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Alla Bru
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Astrid Edland
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Randi Eikeland
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Sonia Gosal
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Hanne F Harbo
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Grethe Kleveland
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Yvonne S Sørenes
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Nina Øksendal
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Frederik Barkhof
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Hugo Vrenken
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Kjell-Morten Myhr
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Lars Bø
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Øivind Torkildsen
- From the Department of Clinical Medicine (I.A.L., K.-M.M., L.B., Ø.T.), University of Bergen; Neuro-SysMed, Department of Neurology, Haukeland University Hospital (I.A.L., K.W., S.S.K., S.W., K.-M.M., Ø.T.), Bergen; St. Olav's University Hospital (K.W.), Trondheim; Department of Immunology and Transfusion Medicine (S.S.K.), Haukeland University Hospital, Bergen, Norway; Department of Radiology and Nuclear Medicine (I.B., F.B., H.V.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, The Netherlands; Norwegian Multiple Sclerosis Registry and Biobank (S.W.), Department of Neurology, Haukeland University Hospital, Bergen; Institute of Clinical Medicine (T.H., H.F.H.), University of Oslo; Department of Neurology, Akershus University Hospital (T.H.), Lørenskog; Department of Neurology (R.M.), Molde Hospital; Department of Neurology (A.B.), Stavanger University Hospital; Department of Neurology (A.E.), Vestre Viken Hospital Trust, Drammen; Department of Research and Education (R.E.), Sørlandet Hospital Trust, Kristiansand; Faculty of Health and Sport Science (R.E.), University of Agder, Grimstad; Department of Neurology (S.G.), Østfold Hospital Kalnes, Grålum; Department of Neurology (H.F.H.), Oslo University Hospital; Department of Neurology (G.K.), Innlandet Hospital Lillehammer; Department of Neurology (Y.S.S.), Haugesund Hospital; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø, Norway; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, Great Britain; and Norwegian Multiple Sclerosis Competence Centre (L.B.), Department of Neurology, Haukeland University Hospital, Bergen, Norway
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Murdock KW, Stowe RP, Engeland CG. Diminished Cellular Immunity and Executive Cognitive Functioning Among Middle-Aged and Elderly Adults. Psychosom Med 2022; 84:679-684. [PMID: 35420592 DOI: 10.1097/psy.0000000000001080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Within the field of psychoneuroimmunology, much attention has been given to immune dysregulation and its impact on cognitive functioning. Some of this work has focused on the association between high levels of basal proinflammatory cytokines and poorer performance on measures of executive functioning; however, effect sizes have been quite small in human studies. METHODS We investigated whether Epstein-Barr virus (EBV) antibody titers, a marker of immune dysregulation related to cellular immunity, may be associated with executive functioning while also attempting to replicate prior studies using two markers of proinflammatory cytokine production (i.e., circulating and lipopolysaccharide [LPS]-stimulated cytokines [interleukin 6, interleukin 1β, interferon-γ]). A total of 71 community-dwelling adults (mean [standard deviation] age = 60.87 [6.26] years) who were seropositive for EBV infection participated in the study. RESULTS Findings indicated that greater EBV antibody titers were associated with poorer performance on measures of the executive functions of inhibition ( B = -2.36, standard error = 1.06, p = .028) and cognitive flexibility ( B = -2.89, standard error = 1.13, p = .013) when including circulating and LPS-stimulated cytokines and other relevant covariates (i.e., age, sex, and body mass index) in linear regression analyses. Neither circulating nor LPS-stimulated cytokines were associated with performance on the cognitive tasks in the regression analyses. CONCLUSIONS These results suggest that EBV antibody titers may be an indicator of immune dysregulation that is more relevant to executive functioning performance than either circulating or stimulated proinflammatory cytokines among community-dwelling adults.
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Affiliation(s)
- Kyle W Murdock
- From the Department of Biobehavioral Health (Murdock, Engeland), The Pennsylvania State University, University Park, Pennsylvania; Microgen Laboratories (Stowe), La Marque, Texas; and College of Nursing, The Pennsylvania State University (Engeland), University Park, Pennsylvania
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25
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Fatima M, Lamis A, Siddiqui SW, Ashok T, Patni N, Fadiora OE. Therapeutic Role of Vitamin D in Multiple Sclerosis: An Essentially Contested Concept. Cureus 2022; 14:e26186. [PMID: 35911285 PMCID: PMC9311493 DOI: 10.7759/cureus.26186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 11/05/2022] Open
Abstract
Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the nervous system with incredibly intricate etiopathogenesis involving numerous genetic, epigenetic, and environmental risk factors. Major environmental risk factors include ultraviolet (UV) radiation, vitamin D, Epstein-Barr virus (EBV) infection, smoking, and high body mass index (BMI). Vitamin D, in particular, can be viewed as one piece of this puzzle, with various tabs and pockets, occupying a sequential site. In this article, we have briefly discussed the neuroimmunology of MS and the role of vitamin D in regulating immune responses. Various observational studies and clinical trials were reviewed and discussed according to stages of disease activity and course of the disease. The data reviewed in this article implied that serum vitamin D levels greatly influence the risk of developing MS and disease activity. Long-term follow-up studies indicated that low serum vitamin D levels correlate with worse disability outcomes. Since clinical trials did not provide significant evidence, the role of vitamin D in controlling disease activity remains unresolved. Larger clinical trials are needed to support the findings of observational studies and provide significant evidence in favour of vitamin D.
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Quintero-Fabián S, Bandala C, Pichardo-Macías LA, Contreras-García IJ, Gómez-Manzo S, Hernández-Ochoa B, Martínez-Orozco JA, Ignacio- Mejía I, Cárdenas-Rodríguez N. Vitamin D and its possible relationship to neuroprotection in COVID-19: evidence in the literature. Curr Top Med Chem 2022; 22:1346-1368. [DOI: 10.2174/1568026622666220401140737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/30/2022] [Accepted: 02/03/2022] [Indexed: 11/22/2022]
Abstract
Abstract:
Vitamin D is a hormone involved in the regulation of important biological processes such as signal transduction, immune response, metabolic regulation and also in the nervous and vascular systems. To date, coronavirus disease 2019 (COVID-19) infection does not have a specific treatment, however various drugs have been proposed, including those that attenuate the intense inflammatory response and recently the use of vitamin D, in clinical trials, as part of the treatment of COVID-19 has provided promising results. It has been observed in some clinical studies that the use of cholecalciferol (vitamin D3) and its two metabolites the circulating form, calcidiol or calcifediol (25-hydroxycalciferol, 25-(OH)-D) and the active form, calcitriol (1,25-(OH)2-D), in different doses, improve the clinical manifestations, prognosis and survival of patients infected with COVID-19 probably because of its anti-inflammatory, antiviral and lung-protective action. In relation to the central nervous system (CNS) it has been shown, in clinical studies, that vitamin D is beneficial in some neurological and psychiatric conditions because of its anti-inflammatory and antioxidant properties, modulation of neurotransmitters actions, regulation of calcium homeostasis between other mechanisms. It has been showed that COVID-19 infection induces CNS complications such as headache, anosmia, ageusia, neuropathy, encephalitis, stroke, thrombosis, cerebral hemorrhages, cytotoxic lesions and psychiatric conditions and it has been proposed that the use of dietary supplements, as vitamin and minerals, can be adjuvants in this disease. In this review the evidence of possible role of vitamin D, and its metabolites, as protector against the neurological manifestations of COVID-19 was summarized.
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Affiliation(s)
- Saray Quintero-Fabián
- Laboratorio de Medicina Traslacional, Escuela Militar de Graduados de Sanidad, UDEFA, Mexico City, 11200, Mexico
| | - Cindy Bandala
- Division de Neurociencias, Instituto Nacional de Rehabilitación, Secretaría de Salud, Mexico City, 14389, Mexico
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, 11340, Mexico
| | - Luz Adriana Pichardo-Macías
- Departamento de Fisiología, Instituto Politécnico Nacional, Escuela Nacional de Ciencias Biológicas, Mexico City, 07738, Mexico
| | | | - Saúl Gómez-Manzo
- Laboratorio de Bioquímica Genética, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, 04530, Mexico
| | - Beatriz Hernández-Ochoa
- Laboratorio de Inmunoquímica, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Mexico City, 06720, Mexico
| | - José Arturo Martínez-Orozco
- Departmento de Infectología, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosío Villegas, Secretaría de Salud, Mexico City, 14080, Mexico
| | - Iván Ignacio- Mejía
- Laboratorio de Medicina Traslacional, Escuela Militar de Graduados de Sanidad, UDEFA, Mexico City, 11200, Mexico
| | - Noemí Cárdenas-Rodríguez
- Laboratorio de Neurociencias, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, 04530, Mexico
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Zorzella-Pezavento SFG, Mimura LAN, Denadai MB, de Souza WDF, Fraga-Silva TFDC, Sartori A. Is there a window of opportunity for the therapeutic use of vitamin D in multiple sclerosis? Neural Regen Res 2022; 17:1945-1954. [PMID: 35142671 PMCID: PMC8848597 DOI: 10.4103/1673-5374.335139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Multiple sclerosis is an autoimmune treatable but not curable disease. There are a multiplicity of medications for multiple sclerosis therapy, including a class entitled disease-modifying drugs that are mainly indicated to reduce the number and severity of disease relapses. Not all patients respond well to these therapies, and minor to severe adverse effects have been reported. Vitamin D, called sunshine vitamin, is being studied as a possible light at the end of the tunnel. In this review, we recapitulated the similar immunopathogenesis of multiple sclerosis and experimental autoimmune encephalomyelitis, the immunomodulatory and neuroprotective potential of vitamin D and the state-of-art concerning its supplementation to multiple sclerosis patients. Finally, based on our and other groups’ experimental findings, we analyzed the need to consider the relevance of the route and the different time-point administration aspects for a more rational indication of this vitamin to multiple sclerosis patients.
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Affiliation(s)
| | - Luiza Ayumi Nishiyama Mimura
- Department of Chemical and Biological Sciences, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Marina Bonifácio Denadai
- Department of Chemical and Biological Sciences, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - William Danilo Fernandes de Souza
- Department of Chemical and Biological Sciences, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | | | - Alexandrina Sartori
- Department of Chemical and Biological Sciences, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
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Virgilio E, Vecchio D, Crespi I, Puricelli C, Barbero P, Galli G, Cantello R, Dianzani U, Comi C. Cerebrospinal fluid biomarkers and cognitive functions at multiple sclerosis diagnosis. J Neurol 2022; 269:3249-3257. [PMID: 35088141 DOI: 10.1007/s00415-021-10945-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 02/06/2023]
Abstract
Cognitive impairment (CI) is a frequent and disabling symptom in Multiple Sclerosis (MS). Axonal damage may contribute to CI development from early stages. Nevertheless, no biomarkers are at the moment available to track CI in MS patients. We aimed to explore the correlation of cerebrospinal fluid (CSF) axonal biomarkers, in particular: light-chain neurofilaments (NFL), Tau, and Beta-amyloid protein (Abeta) in MS patients with CI at the diagnosis. 62 newly diagnosed MS patients were enrolled, and cognition was evaluated using the Brief International Cognitive Assessment for MS (BICAMS) battery. CSF NFL, Abeta, and Tau levels were determined with commercial ELISA. Patients with CI (45.1%) did not differ for demographic, clinical, and MRI characteristics (except for lower educational level), but they displayed greater neurodegeneration, exhibiting higher mean CSF Tau protein (162.1 ± 52.96 pg/ml versus 132.2 ± 63.86 pg/ml p:0.03). No differences were observed for Abeta and NFL. The number of impaired tests and Tau were significantly correlated (r:0.32 p:0.01). Tau was higher in particular in patients with slowed information processing speed (IPS) (p:0.006) and a linear regression analysis accounting for EDSS, MRI, and MS subtype confirmed Tau as a weak predictor of IPS and cognitive impairment. In conclusion, CI has an important burden on the quality of life of MS patients and should be looked for even at diagnosis. Axonal damage biomarkers, and in particular Tau, seem to reflect cognition impairment in the early stages.
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Affiliation(s)
- Eleonora Virgilio
- Department of Translational Medicine, Neurology Unit, Maggiore Della Carità Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy. .,Phd Program in Medical Sciences and Biotechnologies, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy. .,Department of Translational Medicine, Neurology Unit, S. Andrea Hospital, University of Piemonte Orientale, Vercelli, Italy.
| | - Domizia Vecchio
- Department of Translational Medicine, Neurology Unit, Maggiore Della Carità Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy.,Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, Novara, Italy
| | - Ilaria Crespi
- Department of Health Sciences, Clinical Biochemistry, University of Piemonte Orientale, Novara, Italy
| | - Chiara Puricelli
- Department of Health Sciences, Clinical Biochemistry, University of Piemonte Orientale, Novara, Italy
| | - Paolo Barbero
- Department of Translational Medicine, Neurology Unit, Maggiore Della Carità Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy
| | - Giulia Galli
- Department of Translational Medicine, Neurology Unit, Maggiore Della Carità Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy
| | - Roberto Cantello
- Department of Translational Medicine, Neurology Unit, Maggiore Della Carità Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy
| | - Umberto Dianzani
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, Novara, Italy.,Department of Health Sciences, Clinical Biochemistry, University of Piemonte Orientale, Novara, Italy
| | - Cristoforo Comi
- Department of Translational Medicine, Neurology Unit, S. Andrea Hospital, University of Piemonte Orientale, Vercelli, Italy.,Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, Novara, Italy
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Rozmus D, Płomiński J, Augustyn K, Cieślińska A. rs7041 and rs4588 Polymorphisms in Vitamin D Binding Protein Gene (VDBP) and the Risk of Diseases. Int J Mol Sci 2022; 23:ijms23020933. [PMID: 35055118 PMCID: PMC8779119 DOI: 10.3390/ijms23020933] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/13/2022] [Accepted: 01/13/2022] [Indexed: 02/01/2023] Open
Abstract
The purpose of the study was to investigate the role of vitamin D binding protein (VDBP, DBP) and its polymorphism in the vitamin D pathway and human health. This narrative review shows the latest literature on the most popular diseases that have previously been linked to VDBP. Vitamin D plays a crucial role in human metabolism, controlling phosphorus and calcium homeostasis. Vitamin D binding protein bonds vitamin D and its metabolites and transports them to target tissues. The most common polymorphisms in the VDBP gene are rs4588 and rs7041, which are located in exon 11 in domain III of the VDBP gene. rs4588 and rs7041 may be correlated with differences not only in vitamin D status in serum but also with vitamin D metabolites. This review supports the role of single nucleotide polymorphisms (SNPs) in the VDBP gene and presents the latest data showing correlations between VDBP variants with important human diseases such as obesity, diabetes mellitus, tuberculosis, chronic obstructive pulmonary disease, and others. In this review, we aim to systematize the knowledge regarding the occurrence of diseases and their relationship with vitamin D deficiencies, which may be caused by polymorphisms in the VDBP gene. Further research is required on the possible influence of SNPs, modifications in the structure of the binding protein, and their influence on the organism. It is also important to mention that most studies do not have a specific time of year to measure accurate vitamin D metabolite levels, which can be misleading in conclusions due to the seasonal nature of vitamin D.
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Affiliation(s)
- Dominika Rozmus
- Faculty of Biology and Biotechnology, University of Warmia and Mazury, 10-719 Olsztyn, Poland;
- Correspondence:
| | - Janusz Płomiński
- Clinical Department of Trauma-Orthopedic Surgery and Spine Surgery of the Provincial Specialist Hospital in Olsztyn, 10-561 Olsztyn, Poland;
- Department and Clinic of Orthopaedics and Traumatology, Collegium Medicum, University of Warmia and Mazury, 10-719 Olsztyn, Poland
| | - Klaudia Augustyn
- Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland;
| | - Anna Cieślińska
- Faculty of Biology and Biotechnology, University of Warmia and Mazury, 10-719 Olsztyn, Poland;
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Virgilio E, Vecchio D, Crespi I, Barbero P, Caloni B, Naldi P, Cantello R, Dianzani U, Comi C. Serum Vitamin D as a Marker of Impaired Information Processing Speed and Early Disability in Multiple Sclerosis Patients. Brain Sci 2021; 11:brainsci11111521. [PMID: 34827520 PMCID: PMC8615879 DOI: 10.3390/brainsci11111521] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/02/2021] [Accepted: 11/15/2021] [Indexed: 01/18/2023] Open
Abstract
Slowed information processing speed (IPS) is the hallmark and first cognitive domain to be altered in multiple sclerosis (MS) patients. Insufficient serum vitamin D was previously associated with disease development, relapses, and progression, but little is reported on cognition. However, vitamin D and cognitive impairment (CI) in other neurodegenerative diseases have already been linked. We explored the possible correlation between vitamin D and IPS at diagnosis and early disability at last follow-up in 81 MS patients. At diagnosis, we collected vitamin D levels and performed a Symbol Digit Modalities Test (SDMT). Raw scores were adjusted for age, gender, and educational level. Early disability was evaluated with MS severity score (MSSS) and age-related MSSS (ARMSS). A total of 71 patients (86.58%) showed hypovitaminosis D (19.71 ± 8.76 ng/mL) and 18 patients (21.95%) had CI. Patients with CI showed severe hypovitaminosis D (p = 0.004). No patients with sufficient vitamin D levels had CI. We found a positive correlation between vitamin D levels at diagnosis and (1) SDMT raw and z-score that persisted after correction for sunlight exposure and MRI baseline characteristics, and (2) EDSS, MSSS, and ARMSS after a mean 2 year follow-up. Low vitamin D levels may affect both cognition and early disability in newly diagnosed MS patients.
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Affiliation(s)
- Eleonora Virgilio
- Neurology Unit, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (D.V.); (P.B.); (B.C.); (P.N.); (R.C.)
- Ph.D. Program in Medical Sciences and Biotechnologies, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
- Neurology Unit, Department of Translational Medicine, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy;
- Correspondence: ; Tel.: +39-0321-3733964
| | - Domizia Vecchio
- Neurology Unit, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (D.V.); (P.B.); (B.C.); (P.N.); (R.C.)
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Ilaria Crespi
- Clinical Biochemistry, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Paolo Barbero
- Neurology Unit, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (D.V.); (P.B.); (B.C.); (P.N.); (R.C.)
| | - Beatrice Caloni
- Neurology Unit, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (D.V.); (P.B.); (B.C.); (P.N.); (R.C.)
| | - Paola Naldi
- Neurology Unit, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (D.V.); (P.B.); (B.C.); (P.N.); (R.C.)
| | - Roberto Cantello
- Neurology Unit, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (D.V.); (P.B.); (B.C.); (P.N.); (R.C.)
| | - Umberto Dianzani
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy;
- Clinical Biochemistry, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Cristoforo Comi
- Neurology Unit, Department of Translational Medicine, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy;
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy;
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Smoking, obesity, and disability worsening in PPMS: an analysis of the INFORMS original trial dataset. J Neurol 2021; 269:1663-1669. [PMID: 34392376 DOI: 10.1007/s00415-021-10750-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/30/2021] [Accepted: 08/06/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Smoking and obesity are recognized modifiable risk factors associated with a higher MS incidence, but their impact on physical and cognitive disability worsening is less clear. OBJECTIVE To investigate the impact of smoking and obesity on disability worsening in primary progressive MS (PPMS). METHODS We used data from INFORMS (clinicaltrials.gov identifier: NCT00731692), a large randomized-controlled trial in PPMS to compare significant worsening on the EDSS, T25FW, NHPT, and PASAT between smokers and non-smokers, and between BMI groups, at 12, 24, and 33 months of follow-up. We investigated the association of smoking and BMI at screening and the risk of disability worsening with logistic regression models. RESULTS Smokers had significantly higher EDSS scores throughout the trial. EDSS was not significantly different between BMI categories. No other outcome measure was significantly different between smokers and non-smokers and between BMI categories throughout the trial. Neither smoking status nor BMI were associated with significant worsening on any outcome measure at any time point during follow-up. CONCLUSION Despite the known effects on MS incidence, smoking and BMI were not associated with the risk of physical and cognitive disability worsening over 3 years in this well-characterized PPMS trial cohort.
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Ajdacic-Gross V, Steinemann N, Horváth G, Rodgers S, Kaufmann M, Xu Y, Kamm CP, Kesselring J, Manjaly ZM, Zecca C, Calabrese P, Puhan MA, von Wyl V. Onset Symptom Clusters in Multiple Sclerosis: Characteristics, Comorbidities, and Risk Factors. Front Neurol 2021; 12:693440. [PMID: 34295301 PMCID: PMC8290323 DOI: 10.3389/fneur.2021.693440] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/09/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Multiple sclerosis (MS) symptoms are expected to aggregate in specific patterns across different stages of the disease. Here, we studied the clustering of onset symptoms and examined their characteristics, comorbidity patterns and associations with potential risk factors. Methods: Data stem from the Swiss Multiple Sclerosis Registry, a prospective study including 2,063 participants by November 2019. MS onset symptoms were clustered using latent class analysis (LCA). The latent classes were further examined using information on socio-demographic characteristics, MS-related features, potential risk factors, and comorbid diseases. Results: The LCA model with six classes (frequencies ranging from 12 to 24%) was selected for further analyses. The latent classes comprised a multiple symptoms class with high probabilities across several symptoms, contrasting with two classes with solitary onset symptoms: vision problems and paresthesia. Two gait classes emerged between these extremes: the gait-balance class and the gait-paralysis class. The last class was the fatigue-weakness-class, also accompanied by depression symptoms, memory, and gastro-intestinal problems. There was a moderate variation by sex and by MS types. The multiple symptoms class yielded increased comorbidity with other autoimmune disorders. Similar to the fatigue-weakness class, the multiple symptoms class showed associations with angina, skin diseases, migraine, and lifetime prevalence of smoking. Mononucleosis was more frequently reported in the fatigue-weakness and the paresthesia class. Familial aggregation did not differ among the classes. Conclusions: Clustering of MS onset symptoms provides new perspectives on the heterogeneity of MS. The clusters comprise different potential risk factors and comorbidities. They point toward different risk mechanisms.
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Affiliation(s)
- Vladeta Ajdacic-Gross
- Swiss MS Registry, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Nina Steinemann
- Swiss MS Registry, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Gábor Horváth
- Swiss MS Registry, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Stephanie Rodgers
- Swiss MS Registry, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Marco Kaufmann
- Swiss MS Registry, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Yanhua Xu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Christian P Kamm
- Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.,Neurocentre, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Jürg Kesselring
- Department of Neurology and Neurorehabilitation, Rehabilitation Centre Kliniken Valens, Valens, Switzerland
| | - Zina-Mary Manjaly
- Department of Neurology, Schulthess Clinic, Zurich, Switzerland.,Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Chiara Zecca
- Department of Neurology, Multiple Sclerosis Center (MSC), Neurocenter of Southern Switzerland, Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Pasquale Calabrese
- Division of Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland
| | - Milo A Puhan
- Swiss MS Registry, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Viktor von Wyl
- Swiss MS Registry, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Boltjes R, Knippenberg S, Gerlach O, Hupperts R, Damoiseaux J. Vitamin D supplementation in multiple sclerosis: an expert opinion based on the review of current evidence. Expert Rev Neurother 2021; 21:715-725. [PMID: 34058936 DOI: 10.1080/14737175.2021.1935878] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Vitamin D has long been known for its immune-modulating effects, next to its function in calcium metabolism. As a consequence, poor vitamin D status has been associated with many diseases including multiple sclerosis (MS). Epidemiological studies suggest an association between a poor vitamin D status and development of MS and a poor vitamin D status is associated with more relapses and faster progression after patients are diagnosed with MS. AREA’S COVERED The aim of the authors was to review the role of vitamin D supplementation in the treatment of MS. Pubmed was used to review literature with a focus of vitamin D supplementation trials and meta-analyses in MS. EXPERT OPINION There is no solid evidence to support the application of vitamin D therapy, based on current available supplementation trials, although there are some promising results in the clinically isolated syndrome (CIS) patients and young MS patients early after initial diagnosis. The authors recommend further larger clinical trials with selected patient groups, preferable CIS patients and young patients at the time of diagnosis, using vitamin D3 supplements to reach a 100 nmol/l level, to further investigate the effects of vitamin D supplementation in MS.
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Affiliation(s)
- Robin Boltjes
- Academic MS Center Limburg, Department of Neurology, Zuyderland Medical Center, Sittard, The Netherlands
| | - Stephanie Knippenberg
- Academic MS Center Limburg, Department of Neurology, Zuyderland Medical Center, Sittard, The Netherlands
| | - Oliver Gerlach
- Academic MS Center Limburg, Department of Neurology, Zuyderland Medical Center, Sittard, The Netherlands.,School for Mental Health and Neuroscience, Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Raymond Hupperts
- Academic MS Center Limburg, Department of Neurology, Zuyderland Medical Center, Sittard, The Netherlands.,School for Mental Health and Neuroscience, Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan Damoiseaux
- School for Mental Health and Neuroscience, Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.,Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, The Netherlands
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Sunlight exposure exerts immunomodulatory effects to reduce multiple sclerosis severity. Proc Natl Acad Sci U S A 2021; 118:2018457118. [PMID: 33376202 PMCID: PMC7817192 DOI: 10.1073/pnas.2018457118] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Multiple sclerosis (MS) disease risk is associated with reduced sun-exposure. This study assessed the relationship between measures of sun exposure (vitamin D [vitD], latitude) and MS severity in the setting of two multicenter cohort studies (n NationMS = 946, n BIONAT = 990). Additionally, effect-modification by medication and photosensitivity-associated MC1R variants was assessed. High serum vitD was associated with a reduced MS severity score (MSSS), reduced risk for relapses, and lower disability accumulation over time. Low latitude was associated with higher vitD, lower MSSS, fewer gadolinium-enhancing lesions, and lower disability accumulation. The association of latitude with disability was lacking in IFN-β-treated patients. In carriers of MC1R:rs1805008(T), who reported increased sensitivity toward sunlight, lower latitude was associated with higher MRI activity, whereas for noncarriers there was less MRI activity at lower latitudes. In a further exploratory approach, the effect of ultraviolet (UV)-phototherapy on the transcriptome of immune cells of MS patients was assessed using samples from an earlier study. Phototherapy induced a vitD and type I IFN signature that was most apparent in monocytes but that could also be detected in B and T cells. In summary, our study suggests beneficial effects of sun exposure on established MS, as demonstrated by a correlative network between the three factors: Latitude, vitD, and disease severity. However, sun exposure might be detrimental for photosensitive patients. Furthermore, a direct induction of type I IFNs through sun exposure could be another mechanism of UV-mediated immune-modulation in MS.
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Wesnes K, Myhr KM, Riise T, Kvistad SS, Torkildsen Ø, Wergeland S, Holmøy T, Midgard R, Bru A, Edland A, Eikeland R, Gosal S, Harbo HF, Kleveland G, Sørenes YS, Øksendal N, Bjørnevik K. Low vitamin D, but not tobacco use or high BMI, is associated with long-term disability progression in multiple sclerosis. Mult Scler Relat Disord 2021; 50:102801. [PMID: 33636616 DOI: 10.1016/j.msard.2021.102801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Low vitamin D levels, tobacco use and high body mass index (BMI) have been linked to adverse disease outcomes in multiple sclerosis (MS), but their influence on long-term disability progression remains unclear. Therefore, we explored whether these modifiable lifestyle factors were associated with 10-year clinical disability progression in patients with MS. METHODS In this prospective study, a cohort of 88 patients with relapsing-remitting MS completed a randomized controlled study on ω-3 fatty acids between 2004 and 2008. During 24 months, serum 25-hydroxyvitamin D (25(OH)D), serum cotinine (nicotine metabolite), and BMI were repeatedly measured. In 2017, a follow-up study was conducted among 80 of the participants, including disability assessment by the Expanded Disability Status Scale (EDSS). Linear regression was used to explore associations between the lifestyle factors and the EDSS change over 10 years. RESULTS Higher seasonally adjusted 25(OH)D levels were associated with lower 10-year EDSS progression (change in EDSS per 1 SD increase in 25(OH)D in a model adjusted for sex, age and baseline EDSS: -0.45 point, 95% CI: -0.75 to -0.16, p=0.003). Further adjustments for potential confounders related to lifestyle and disease status gave similar results. The association was mainly driven by low 25(OH)D levels during spring, as well as seasonally adjusted levels below 80 nmol/L. No clear association was found for BMI and cotinine. CONCLUSION Lower 25(OH)D levels, but apparently not tobacco use or higher BMI, were significantly associated with worse long-term disability progression in MS.
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Affiliation(s)
- Kristin Wesnes
- Department of Clinical Medicine, University of Bergen, Bergen, Norway; Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway; Department of Neurology, St. Olav's University Hospital, Trondheim, Norway.
| | - Kjell-Morten Myhr
- Department of Clinical Medicine, University of Bergen, Bergen, Norway; Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Trond Riise
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Silje Stokke Kvistad
- Department of Clinical Medicine, University of Bergen, Bergen, Norway; Department of Immunology and Transfusion medicine, Haukeland University Hospital, Bergen, Norway
| | - Øivind Torkildsen
- Department of Clinical Medicine, University of Bergen, Bergen, Norway; Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Stig Wergeland
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway; Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Trygve Holmøy
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Rune Midgard
- Department of Neurology, Molde Hospital, Molde, Norway
| | - Alla Bru
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway
| | - Astrid Edland
- Department of Neurology, Vestre Viken Hospital Trust, Drammen, Norway
| | - Randi Eikeland
- Department of Neurology and Department of Paediatrics, Sørlandet Hospital Trust, Arendal, Norway
| | - Sonia Gosal
- Department of Neurology, Østfold Hospital Kalnes, Grålum, Norway
| | - Hanne F Harbo
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Neurology, Oslo University Hospital Ullevaal, Oslo, Norway
| | - Grethe Kleveland
- Department of Neurology, Innlandet Hospital Lillehammer, Lillehammer, Norway
| | | | - Nina Øksendal
- Department of Neurology, Nordland hospital trust, Bodø, Norway
| | - Kjetil Bjørnevik
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Ruprecht K. The role of Epstein-Barr virus in the etiology of multiple sclerosis: a current review. Expert Rev Clin Immunol 2020; 16:1143-1157. [PMID: 33152255 DOI: 10.1080/1744666x.2021.1847642] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. While its exact etiology is unknown, it is generally believed that MS is caused by environmental triggers in genetically predisposed individuals. Strong and consistent evidence suggests a key role of Epstein-Barr virus (EBV), a B lymphotropic human gammaherpesvirus, in the etiology of MS. Areas covered: This review summarizes recent developments in the field of EBV and MS with a focus on potential mechanisms underlying the role of EBV in MS. PubMed was searched for the terms 'Epstein-Barr virus' and 'multiple sclerosis'. Expert opinion: The current evidence is compatible with the working hypothesis that MS is a rare complication of EBV infection. Under the premise of a causative role of EBV in MS, it needs to be postulated that EBV causes a specific, and likely persistent, change(s) that is necessarily required for the development of MS. However, although progress has been made, the nature of that change and thus the precise mechanism explaining the role of EBV in MS remain elusive. The mechanism of EBV in MS therefore is a pressing question, whose clarification may substantially advance the pathophysiological understanding, rational therapies, and prevention of MS.
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Affiliation(s)
- Klemens Ruprecht
- Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health , Berlin, Germany
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Barro C, Chitnis T, Weiner HL. Blood neurofilament light: a critical review of its application to neurologic disease. Ann Clin Transl Neurol 2020; 7:2508-2523. [PMID: 33146954 PMCID: PMC7732243 DOI: 10.1002/acn3.51234] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/12/2020] [Indexed: 02/06/2023] Open
Abstract
Neuronal injury is a universal event that occurs in disease processes that affect both the central and peripheral nervous systems. A blood biomarker linked to neuronal injury would provide a critical measure to understand and treat neurologic diseases. Neurofilament light chain (NfL), a cytoskeletal protein expressed only in neurons, has emerged as such a biomarker. With the ability to quantify neuronal damage in blood, NfL is being applied to a wide range of neurologic conditions to investigate and monitor disease including assessment of treatment efficacy. Blood NfL is not specific for one disease and its release can also be induced by physiological processes. Longitudinal studies in multiple sclerosis, traumatic brain injury, and stroke show accumulation of NfL over days followed by elevated levels over months. Therefore, it may be hard to determine with a single measurement when the peak of NfL is reached and when the levels are normalized. Nonetheless, measurement of blood NfL provides a new blood biomarker for neurologic diseases overcoming the invasiveness of CSF sampling that restricted NfL clinical application. In this review, we examine the use of blood NfL as a biologic test for neurologic disease.
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Affiliation(s)
- Christian Barro
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tanuja Chitnis
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Howard L Weiner
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Andersen O, Filippi M. Predictive MS risk factors and axonal disintegration. Neurology 2020; 94:771-772. [PMID: 32300061 DOI: 10.1212/wnl.0000000000009367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Oluf Andersen
- From the Department of Clinical Neuroscience (O.A.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Neurology, Sahlgrenska University Hospital, Göteborg, Sweden; Neuroimaging Research Unit (M.F.), Division of Neuroscience, Neurology Unit and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; and Vita-Salute San Raffaele University (M.F.), Milan, Italy.
| | - Massimo Filippi
- From the Department of Clinical Neuroscience (O.A.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Neurology, Sahlgrenska University Hospital, Göteborg, Sweden; Neuroimaging Research Unit (M.F.), Division of Neuroscience, Neurology Unit and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; and Vita-Salute San Raffaele University (M.F.), Milan, Italy
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