Exposure to environmental tobacco smoke is associated with increased risk for multiple sclerosis

Hedström, AK; Bäärnhielm, Maria; Olsson, Tomas; Alfredsson, Lars

doi:10.1177/1352458511399610

Cited by 108 publications

(71 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The cause of MS is yet to be elucidated but several genetic and environmental factors have been linked to increased risk of developing MS. The risk factors include female gender [1], exposure to Epstein-Barr virus (EBV) [2], low vitamin D (25-hydroxy vitamin D) status [3], low exposure to ultraviolet (UV) radiation [4], smoking [5][6][7], childhood and adolescent obesity [8][9][10][11], and having the HLA-DRB1*15 allele [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for multiple sclerosis and associations with anti-EBV antibody titers

Mouhieddine

Darwish

Fawaz

et al. 2015

Clinical Immunology

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Risk factors for multiple sclerosis and associations with anti-EBV antibody titers

Mouhieddine

Darwish

Fawaz

et al. 2015

Clinical Immunology

View full text Add to dashboard Cite

“…Many environmental risk factors for conversion from CIS to MS were shown in recent studies (1,2). Among these, cigarette smoking was shown to increase the risk of developing MS even in passive smokers (3), worsen clinical disability, and exacerbate disease progression (4) .…”

mentioning

confidence: 99%

Influence of cigarette smoking on white matter in patients with clinically isolated syndrome as detected by diffusion tensor imaging

Durhan¹,

Diker²,

Has³

et al. 2016

Diagn Interv Radiol

View full text Add to dashboard Cite

C linically isolated syndrome (CIS), an inflammatory demyelinating disorder of the central nervous system, is the first clinical episode with features predictive of multiple sclerosis (MS) (1). Many environmental risk factors for conversion from CIS to MS were shown in recent studies (1,2). Among these, cigarette smoking was shown to increase the risk of developing MS even in passive smokers (3), worsen clinical disability, and exacerbate disease progression (4) .Diffusion tensor imaging (DTI) gives the opportunity to evaluate the tissue integrity, mainly the white matter (WM). Through changes in metrics such as fractional anisotropy (FA) and mean diffusivity (MD), DTI enables the assessment of axonal organization and myelin attenuation in addition to the WM lesions evaluated by conventional magnetic resonance imaging (MRI) sequences (5). The brains of MS patients have demonstrated that an increase in MD and a decrease in FA values were far beyond fluid attenuation inversion recovery (FLAIR) hyperintense lesions, commonly used as a clinical parameter of MS (6, 7). Brain parenchyma with no apparent lesion, namely, the normal-appearing white matter (NAWM), has drawn much attention due to the presence of not only histopathologic and radiologic abnormalities but also a close association with clinical disability and disease progression (8). Changes in the NAWM may also be responsible for the clinicoradiologic discrepancy observed in many patients (6). In addition, several MRI studies have shown significantly altered FA measures in specific brain regions in healthy smoker individuals (9, 10). Although a number of studies have investigated the impact of smoking on patients with MS (4,11), to the best of our knowledge, no study has studied the influence of smoking on the WM in patients with CIS using DTI.In this study we sought to determine the effects of smoking on NAWM, lesions, and perilesional WM of patients with CIS. The secondary objective was to examine whether diffu- PURPOSECigarette smoking has been associated with increased occurrence of multiple sclerosis (MS), as well as clinical disability and disease progression in MS. We aimed to assess the effects of smoking on the white matter (WM) in patients with clinically isolated syndrome (CIS) using diffusion tensor imaging. METHODSSmoker patients with CIS (n=16), smoker healthy controls (n=13), nonsmoker patients with CIS (n=17) and nonsmoker healthy controls (n=14) were included. Thirteen regions-of-interest including nonenhancing T1 hypointense lesion and perilesional WM, and 11 normal-appearing white matter (NAWM) regions were drawn on color-coded fractional anisotropy (FA) maps. Lesion load was determined in terms of number and volume of WM hyperintensities. RESULTSA tendency towards greater lesion load was found in smoker patients. T1 hypointense lesions and perilesional WM had reduced FA and increased mean diffusivity to a similar degree in smoker and nonsmoker CIS patients. Compared with healthy smokers, smoker CIS patients had more extensive NAWM changes...

show abstract

“…In a Swedish case-control study, the incidence of MS among never-smokers who had been exposed to passive smoking was higher than among those who had never been exposed (OR 1.3, 95 % CI 1.1-1.6) (Hedström et al 2011b). The risk increased with longer duration of exposure.…”

Section: Passive Smokingmentioning

confidence: 98%

The Role of Environment and Lifestyle in Determining the Risk of Multiple Sclerosis

Hedström

Olsson

Alfredsson

2015

Current Topics in Behavioral Neurosciences

View full text Add to dashboard Cite

MS is a complex disease where both genetic and environmental factors contribute to disease susceptibility. The substantially increased risk of developing MS in relatives of affected individuals gives solid evidence for a genetic base for susceptibility, whereas the modest familial risk, most strikingly demonstrated in the twin studies, is a very strong argument for an important role of lifestyle/environmental factors in determining the risk of MS, sometimes interacting with MS risk genes. Lifestyle factors and environmental exposures are harder to accurately study and quantify than genetic factors. However, it is important to identify these factors since they, as opposed to risk genes, are potentially preventable. We have reviewed the evidence for environmental factors that have been repeatedly shown to influence the risk of MS: Epstein-Barr virus (EBV) infection, ultraviolet radiation (UVR) exposure habits /vitamin D status, and smoking. We have also reviewed a number of additional environmental factors, published in the past 5 years, that have been described to influence MS risk. Independent replication, preferably by a variety of methods, may give still more firm evidence for their involvement.

show abstract

Exposure to environmental tobacco smoke is associated with increased risk for multiple sclerosis

Cited by 108 publications

References 19 publications

Risk factors for multiple sclerosis and associations with anti-EBV antibody titers

Risk factors for multiple sclerosis and associations with anti-EBV antibody titers

Influence of cigarette smoking on white matter in patients with clinically isolated syndrome as detected by diffusion tensor imaging

The Role of Environment and Lifestyle in Determining the Risk of Multiple Sclerosis

Contact Info

Product

Resources

About