Increasing prevalence and incidence of multiple sclerosis in South East Wales

Hirst, Claire Louise; Ingram, Gillian; Pickersgill, Trevor; Swingler, Robert; Compston, D. A. S.; Robertson, Neil

doi:10.1136/jnnp.2008.144667

Cited by 126 publications

(115 citation statements)

References 21 publications

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“…Our data showing an increasing prevalence over a period of decades is consistent with several studies conducted in the northern hemisphere [6,7,8,9] and in another southern hemispheric country, Australia [10,11,12,13]. Repeated surveys in several Australian cities including Perth, Newcastle and Hobart, Tasmania, have shown increases in MS prevalence between 1951 and 2009 [10,11,12,13].…”

Section: Discussionsupporting

confidence: 78%

“…A number of studies [6,7,8,9] on the prevalence and incidence of MS in the northern hemisphere suggest a steady rise in the absolute number of cases identified. In the southern hemisphere, repeated surveys in the previously surveyed regions of Australia [10,11,12,13] have also shown a consistent trend of increasing prevalence and incidence of MS over time.…”

Section: Introductionmentioning

confidence: 99%

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The Increasing Prevalence of Multiple Sclerosis in New Zealand

et al. 2014

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Background: New Zealand (NZ) has a high prevalence of multiple sclerosis (MS). Worldwide, the prevalence of MS appears to be increasing. Objectives: To review all published prevalence studies undertaken in NZ to determine whether the prevalence of MS in NZ is increasing. Methods: PubMed, Medline, Scopus, Web of Knowledge, EMBASE, AMED and CINAHL were searched to identify studies reporting the prevalence of MS in NZ. Prevalence rates from the National MS Prevalence study in 2006 were compared with earlier prevalence rates for the same regions using Poisson regression. Results: Prevalence rates reported in the earlier regional studies ranged from 23.6 to 68.5/100,000 population; in the same regions in 2006, the range was 47.6-134.2/100,000 population. Prevalence rates were significantly increased in all regions studied except for the Bay of Plenty. The increase in prevalence was seen in both sexes. The sex ratio remained constant over time. Conclusions: In studies spanning almost 40 years (1968-2006), the prevalence of MS within the same regions of NZ has significantly increased whereas the sex ratio and latitudinal gradient have remained stable.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

The Increasing Prevalence of Multiple Sclerosis in New Zealand

et al. 2014

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“…Other explanatory factors for an increasing MS incidence are largely unknown but changes in environmental factors have been suggested [28,29]. In line with our study, several other studies reported that the increasing MS incidence was mostly attributable to an increase among women [23,25,27,30,31,32,33,34]. Solid evidence for the shift in F:M sex ratio is yet unknown but perhaps changing lifestyle factors among women, e.g.…”

Section: Discussionsupporting

confidence: 82%

Incidence of Multiple Sclerosis in the General Population in the Netherlands, 1996–2008

et al. 2012

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Background: We estimated the multiple sclerosis (MS) incidence in the Netherlands for better active monitoring of potential vaccine safety signals. Methods: A retrospective cohort study (1996–2008) was conducted using a population-based general practice research database containing electronic medical records. Additional information was collected to validate incident probable cases. Results: In the source population (648,656 persons), 146 incident probable MS cases were identified. Overall incidence rate was 6.3/100,000 person years (py; 95% CI, 5.2–7.2). In the subgroup in which MS could be fully validated, the incidence increased from 4/100,000 py (95% CI, 3–5) in 1996–2004 to 9/100,000 py in 2007/8 (95% CI, 6–16). This increase was highest among women, but not statistically significantly different by gender. The median lag time between first recorded symptoms and MS diagnosis decreased from 32 months (<1998) to 2 months (>2005). Conclusions: MS is rare in the Netherlands. In recent years, there was a slight increase in the incidence especially among women during the fertile age. This increase coincided with a decrease in lag time between symptoms and diagnosis, both for men and women. This trend should be taken into account in the interpretation of MS cases occurring in a population where new vaccinations will be introduced shortly.

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“…Recent estimates put the sex ratio between ϳ3:1 (28) and ϳ5:1 (30), depending on the decade of birth. An increase in the female bias of MS has been observed in the United States (26,77), Canada (28,30), Australia (78), the United Kingdom (29,79), Norway (27,80), and Sardinia (81), due to an increased incidence among women, rather than to a decreased incidence among men. One explanation for the female bias could be X-linked risk factors, but extensive X chromosome linkage studies have not revealed MS susceptibility loci (82), and the rapidity of the femaleto-male sex ratio increase argues against a genetic origin (28).…”

Section: Discussionmentioning

confidence: 99%

Estrogen Controls Vitamin D3-Mediated Resistance to Experimental Autoimmune Encephalomyelitis by Controlling Vitamin D3 Metabolism and Receptor Expression

Nashold

Spach

Spanier

et al. 2009

The Journal of Immunology

133

104

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Multiple sclerosis (MS) is an autoimmune, neurodegenerative disease with a rapidly increasing female gender bias. MS prevalence decreases with increasing sunlight exposure, supporting our hypothesis that the sunlight-dependent hormone 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) is a natural inhibitor of autoimmune T cell responses in MS. We found that vitamin D3 inhibited experimental autoimmune encephalomyelitis (EAE) in intact female mice, but not in ovariectomized females or males. To learn whether 17β-estradiol (E2) is essential for vitamin D3-mediated protection, ovariectomized female mice were given E2 or placebo and evaluated for vitamin D3-mediated EAE resistance. Diestrus-level E2 implants alone provided no benefit, but they restored vitamin D3-mediated EAE resistance in the ovariectomized females. Synergy between E2 and vitamin D3 occurred through vitamin D3-mediated enhancement of E2 synthesis, as well as E2-mediated enhancement of vitamin D receptor expression in the inflamed CNS. In males, E2 implants did not enable vitamin D3 to inhibit EAE. The finding that vitamin D3-mediated protection in EAE is female-specific and E2-dependent suggests that declining vitamin D3 supplies due to sun avoidance might be contributing to the rapidly increasing female gender bias in MS. Moreover, declining E2 synthesis and vitamin D3-mediated protection with increasing age might be contributing to MS disease progression in older women.

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Increasing prevalence and incidence of multiple sclerosis in South East Wales

Cited by 126 publications

References 21 publications

The Increasing Prevalence of Multiple Sclerosis in New Zealand

The Increasing Prevalence of Multiple Sclerosis in New Zealand

Incidence of Multiple Sclerosis in the General Population in the Netherlands, 1996–2008

Estrogen Controls Vitamin D3-Mediated Resistance to Experimental Autoimmune Encephalomyelitis by Controlling Vitamin D3 Metabolism and Receptor Expression

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