Oral contraceptives and reproductive factors in multiple sclerosis incidence

Villard-Mackintosh, L; Vessey, Martin

doi:10.1016/0010-7824(93)90088-o

Cited by 156 publications

(127 citation statements)

References 4 publications

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“…No case-control difference in smoking was detected, but there is just a statement to this effect without further supporting information. Furthermore, rheumatoid arthritis has a known association with smoking [13]; (iii) a study from Ferrara, Italy [14], containing 104 cases and 150 controls which showed no significant difference for 'smoking and drinking in adolescence', but further details are not given; (iv) two positive studies from Spain with insufficient data for analysis as described above [6,7]; (v) a negative study from North England [2], already described; (vi) the initial study from Oxford [3], which was supplemented by a later publication [4].…”

Section: Search Methodsmentioning

confidence: 99%

Smoking is a risk factor for multiple sclerosis: a metanalysis

Hawkes¹

2007

Mult Scler

126

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Several case control studies have probed a link between cigarette smoking and subsequent multiple sclerosis (MS). Data collection and statistical methods have varied, and frequently, case numbers have been small. Publications relating to MS and smoking are reviewed and combined where comparable methods have been used. Metanalysis of six informative studies show significantly elevated odds or rate ratios, ranging from 1.22 to 1.51, depending on the method of analysis, confirming that the risk of MS is increased for those who smoke prior to disease onset, as measured by commencement of symptoms. A variety of direct causative mechanisms are discussed, but an indirect association through health adverse conduct is favoured. Multiple Sclerosis 2007; 13: 610 Á 615.

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Section: Search Methodsmentioning

confidence: 99%

Smoking is a risk factor for multiple sclerosis: a metanalysis

Hawkes¹

2007

Mult Scler

126

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“…In addition, clinical disease often abates during pregnancy, a time distinguished by an increase in sex hormones, and exacerbates postpartum when sex hormones are at low levels (6,7). There are also reports suggesting a link between oral contraceptive use and a reduction in disability in women with MS (8,9), although the use of oral contraceptives does not appear to reduce the risk of developing MS (10). Consequently, sex hormones such as estrogen are considered important regulators of disease activity and are the focus of ongoing clinical trials for the treatment of MS (R. Voskuhl, unpublished observation).…”

Section: Ultiple Sclerosis (Ms)mentioning

confidence: 99%

Estrogen Treatment Down-Regulates TNF-α Production and Reduces the Severity of Experimental Autoimmune Encephalomyelitis in Cytokine Knockout Mice

Ito¹,

Bebo

Matejuk³

et al. 2001

The Journal of Immunology

247

201

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A shift toward Th2 cytokine production has been demonstrated during pregnancy and high dose estrogen therapy and is thought to be the primary mechanism by which estrogen suppresses the development of experimental autoimmune encephalomyelitis. However, low dose estrogen treatment is equally protective in the absence of a significant shift in cytokine production. In this study cytokine-deficient mice were treated with estrogen to determine whether a shift in Th2 cytokine production was required for the protective effects of hormone therapy. Estrogen effectively suppressed the development of experimental autoimmune encephalomyelitis in IL-4 and IL-10 knockout mice and in wild type littermate mice with a similar potency of protection. Significant disease suppression was also seen in IFN-γ-deficient mice. The decrease in disease severity was accompanied by a concomitant reduction in the number of proinflammatory cytokine- and chemokine-producing cells in the CNS. Although there was no apparent increase in compensatory Th2 cytokine production in cytokine-deficient mice, there was a profound decrease in the frequency of TNF-α-producing cells in the CNS and the periphery. Therefore, we propose that one mechanism by which estrogen protects females from the development of cell-mediated autoimmunity is through a hormone-dependent regulation of TNF-α production.

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“…Three studies (two in the United Kingdom, one in the United States) reported MS incidence only among women. 6,25,26 Table 1 lists the studies included in the systematic review, and their corresponding MS incidence rates and lifetime risk.…”

mentioning

confidence: 99%