Autoimmune disease in people with multiple sclerosis and their relatives: a systematic review and meta-analysis

Dobson, Ruth; Giovannoni, Gavin

doi:10.1007/s00415-012-6790-1

Cited by 67 publications

(49 citation statements)

References 48 publications

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“…In relation to autoimmune diseases, which are generally less common in the general population than more general comorbidities, our magnitudes of effect are in line with the findings of a re-cent meta-analysis [29] , although our findings did not reach statistical significance. For example, in the metaanalysis, the pooled odds ratio for type 1 diabetes was 2.02 (95% CI 1.22-3.40) and the pooled odds ratio for thyroid dysfunction was 1.66 (95% CI 1.35-2.05), while in our study the PR for type 1 diabetes was 2.01 (95% CI 0.23-7.27), and for thyroid dysfunction was 1.67 (95% CI 0.83-3.00) [29] . Our estimate of effect for psoriasis was stronger and in the same direction (PR 2.65 (95% CI 1.48-4.38)) as the pooled estimate of 1.31 (95% CI 1.09-1.57) in the meta-analysis [29] .…”

Section: Discussionsupporting

confidence: 79%

“…For example, in the metaanalysis, the pooled odds ratio for type 1 diabetes was 2.02 (95% CI 1.22-3.40) and the pooled odds ratio for thyroid dysfunction was 1.66 (95% CI 1.35-2.05), while in our study the PR for type 1 diabetes was 2.01 (95% CI 0.23-7.27), and for thyroid dysfunction was 1.67 (95% CI 0.83-3.00) [29] . Our estimate of effect for psoriasis was stronger and in the same direction (PR 2.65 (95% CI 1.48-4.38)) as the pooled estimate of 1.31 (95% CI 1.09-1.57) in the meta-analysis [29] .…”

Section: Discussionmentioning

confidence: 52%

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Frequency of Comorbidities and Their Association with Clinical Disability and Relapse in Multiple Sclerosis

et al. 2016

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Background: Multiple sclerosis (MS) patients may be at an increased risk of comorbidities due to the debilitating and chronic nature of the disease. An increased understanding of comorbidities and disease course in MS may provide new insights and enhance MS management. We aimed at investigating the frequency of comorbidities and their associations with clinical disability and relapse in MS. Methods: A prospective cohort of 198 MS patients was followed during 2002-2005 and queried about specific doctor-diagnosed comorbidities. In Australia, the MS cohort was compared to the 2007 general population with regard to the prevalence of comorbidities. Multilevel mixed-effects linear regression was used to assess the difference in subsequent disability between those who reported comorbidities and those who did not. The association of comorbidities with the hazard of relapse was assessed using survival analysis. Results: The age-standardised prevalence of hypertension, dyslipidaemia, asthma, psoriasis, eczema and anaemia was significantly higher in the MS cohort compared to that in the general Australian population. The level of disability (Multiple Sclerosis Severity Score) in those who reported overweight/obesity (β: 0.76 (95% CI 0.04-1.48), p = 0.037), or dyslipidaemia (β: 1.05 (95% CI 0.07-2.02), p = 0.036) was significantly higher compared to those who did not report these comorbidities, even after adjustment for potential confounders. There were no significant associations between comorbidities and change in disability. For relapse analyses, rheumatoid arthritis and anaemia were associated with more than threefold (hazard ratio, HR 3.70 (95% CI 1.80-7.58), p < 0.001) and twofold (HR 2.04 (95% CI 1.11-3.74), p = 0.022) increased risk of subsequent relapse respectively. Conclusions: The prevalence of some comorbidities was higher in MS patients and associated with greater disability and relapse risk. Treatment of these comorbidities in patients with MS has the potential to improve disease course and help in the understanding of the prognosis and outcomes of MS.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 52%

Frequency of Comorbidities and Their Association with Clinical Disability and Relapse in Multiple Sclerosis

et al. 2016

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“…Their expression is positively correlated with expression of other transcription factor genes, notably RUNX3 and TOX; and with the chemokine ligand gene CCL5 -suggesting a particular blood immune cell subset(s) with the gene expression signature of these genes is either driving MS susceptibility or represents a disease effect in ETlow individuals. Autoimmune conditions are over-represented in MS families [16], and since EOMES is also associated with at least one other autoimmune condition, rheumatoid arthritis [17], the ETlow phenotype may indicate risk to this and other conditions.…”

Section: Introductionmentioning

confidence: 99%

The low EOMES/TBX21 molecular phenotype in multiple sclerosis reflects CD56+ cell dysregulation and is affected by immunomodulatory therapies

McKay

Gatt

Fewings

et al. 2016

Clinical Immunology

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Multiple Sclerosis (MS) is an autoimmune disease treated by therapies targeting peripheral blood cells. We previously identified that expression of two MS-risk genes, the transcription factors EOMES and TBX21 (ET), was low in blood from MS and stable over time. Here we replicated the low ET expression in a new MS cohort (p<0.0007 for EOMES, p < 0.028 for TBX21) and demonstrate longitudinal stability (p<10 -4 ) and high heritability (h 2 =0.48 for EOMES) for this molecular phenotype. Genes whose expression correlated with ET, especially those controlling cell migration, further defined the phenotype. CD56+ cells and other subsets expressed lower levels of Eomes or T-bet protein and/or were underrepresented in MS. EOMES and TBX21 risk SNP genotypes, and serum EBNA-1 titres were not correlated with ET expression, but HLA-DRB1*1501 genotype was. ET expression was normalised to healthy control levels with natalizumab, and was highly variable for glatiramer acetate, fingolimod, interferon-beta, dimethyl fumarate.

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“…These studies mentioned that both diseases have aberrant induction of IFN-γ+ Th1 cells and IL-17+ Th17 cells [8][9][10]. Barcellos et al [11] reported that autoimmune diseases tend to be clustered with other autoimmune diseases in the same patients or among family members.…”

Section: Introductionmentioning

confidence: 99%

Increase Risk of Multiple Sclerosis in Patients with Psoriasis Disease: An Evidence of Observational Studies

et al. 2019

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Background: Psoriasis, a common chronic inflammatory disease, increases the risk of developing multiple sclerosis (MS), but evidence for this outcome is still unclear. However, we performed a meta-analysis of relevant studies to quantify the magnitude of the association between psoriasis and MS. It will help to assess the current state of knowledge, fill the gaps in our existing concern, and make a recommendation for future research. Methods: PubMed, EMBASE, and the bibliographies of articles were searched for studies published between January 1, 1990, and November 1, 2017, which reported on the association between psoriasis and MS. Articles were included if they (1) were published in English, (2) reported patients with psoriasis, and the outcome of interest was MS, (3) provided OR/RR/HR with 95% CI or sufficient information to calculate the 95% CI, and (4) if ≥50 patients. All abstracts, full-text articles, and sources were reviewed, with duplicate data excluded. Summary relative risk (ORs) with 95% CI was pooled using a random-effects model. Subgroup and sensitivity analyses were also conducted. Results: We selected 11 articles out of 785 unique abstracts for full-text review using our predetermined selection criteria, and 9 out of these 11 studies met all of our inclusion criteria. The overall pooled increased of developing MS in patients with psoriasis was RR 1.607 (95% CI 1.322–1.953, p < 0.0001) with low heterogeneity (I² = 37.41%, Q = 12.782, τ² = 0.027) for the random effect model. In the subgroup analysis, the MS risk in the patient with psoriasis was also significantly higher in the 6 studies from Europe RR 1.57 (95% CI 1.26–1.94, p < 0.001) with moderate heterogeneity (I² = 50.66%, Q = 10.13, τ² = 0.03) for the random effect model. Conclusion: Our results showed that psoriasis is significantly associated with an increased risk of developing MS. Physicians should carefully be observed symptoms and empower their patients to improve existing knowledge and quality of life. Further studies are warranted to establish the mechanisms underlying this relationship.

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Autoimmune disease in people with multiple sclerosis and their relatives: a systematic review and meta-analysis

Cited by 67 publications

References 48 publications

Frequency of Comorbidities and Their Association with Clinical Disability and Relapse in Multiple Sclerosis

Frequency of Comorbidities and Their Association with Clinical Disability and Relapse in Multiple Sclerosis

The low EOMES/TBX21 molecular phenotype in multiple sclerosis reflects CD56+ cell dysregulation and is affected by immunomodulatory therapies

Increase Risk of Multiple Sclerosis in Patients with Psoriasis Disease: An Evidence of Observational Studies

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