Role of environmental factors in multiple sclerosis

Zarghami, Amin; Liu, Ying; Claflin, Suzi B.; Mei, Ingrid van der; Taylor, Bruce

doi:10.1080/14737175.2021.1978843

Cited by 33 publications

(24 citation statements)

References 216 publications

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“…Instead, they may reflect factors from an earlier period only now becoming evident in their effects. Alongside genetic determinants,3 4 multiple environmental factors have been associated with MS risk, including sun exposure/vitamin D, body mass index/obesity, and smoking,3 4 19 the distributions of which have changed markedly over time. For example, childhood/adolescent obesity rates have increased dramatically in Australia over the last 40 years as they have done globally 20.…”

Section: Discussionmentioning

confidence: 99%

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Increasing incidence and prevalence of multiple sclerosis in the Greater Hobart cohort of Tasmania, Australia

Simpson‐Yap

Atvars

Blizzard

et al. 2022

J Neurol Neurosurg Psychiatry

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BackgroundThe Greater Hobart region (42.5°S) of Tasmania has consistently had the highest recorded prevalence and incidence rates of multiple sclerosis (MS) in Australia. We reassessed MS epidemiology in 2009–2019 and assessed longitudinal changes over 68 years.MethodsCases recruited from clinic-based datasets and multiple other data sources. 2019 prevalence and 2009–2019 annual incidence and mortality rates estimated, and differences assessed using Poisson regression.Results436 MS cases resident on prevalence day were identified, and 130 had symptom onset within 2009–2019. Prevalence 197.1/100 000 (95% CI 179.4 to 216.5; 147.2/100 000 age standardised, 95% CI 126.5 to 171.3), a 36% increase since 2001 and 3.1-fold increase since 1961. 2009–2019 incidence rate=5.9/100 000 person-years, 95% CI 5.0 to 7.0 (6.1/1000 000 age standardised, 95% CI 4.7 to 7.9), a 2.8-fold increase since 1951–1961 and 65% since 2001–2009. 2009–2019 mortality rate=1.5/100 000 person-years, 95% CI 1.1 to 2.2 (0.9/100 000 age standardised, 95% CI 0.4 to 1.7), comparable to 2001–2009 (1.0/100 000) but reduced by 61% from 1951 to 1959 (2.1/100 000). 2001–2009 standardised mortality ratio=1.0 in 2009–2019, decreased from 2.0 in 1971–1979. Female:male prevalence sex ratio was 2.8, comparable to the 2009 value (2.6); incidence sex ratio (2.9) increased from 2001 to 9 (2.1). Comparisons with Newcastle, Australia (latitude=32.5°S) demonstrate a near complete abrogation of the latitudinal gradients for prevalence (ratio=1.0) and incidence (ratio=1.1), largely attributable to changing Hobart demography.ConclusionsPrevalence and incidence of MS continue to increase significantly in Hobart, alongside marked reductions in mortality and increased case longevity. The marked increase in incidence is of particular note and may reflect longstanding changes in MS risk behaviours including changing sun exposure, obesity rates, and smoking behaviours, particularly in females. Falling mortality contributes to increase longevity and prevalence, likely reflecting improved overall MS healthcare and implementation of disease-modifying therapy.

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Section: Discussionmentioning

confidence: 99%

“…Multiple sclerosis (MS) is a complex disease with both neurodegenerative and neuroinflammatory components 1 2. Environmental and lifestyle factors are associated with the onset of MS, and these are particularly important in those with an increased genetic risk for MS 3 4…”

Section: Introductionmentioning

confidence: 99%

Increasing incidence and prevalence of multiple sclerosis in the Greater Hobart cohort of Tasmania, Australia

Simpson‐Yap

Atvars

Blizzard

et al. 2022

J Neurol Neurosurg Psychiatry

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“…The incidence and prevalence of MS vary geographically, with the prevalence increasing with geographic latitude. A number of studies have found an inverse relationship between sun exposure, ultraviolet radiation exposure, or serum vitamin D levels, and the prevalence of MS (40). Smoking increases the risk of developing MS and may also be a risk factor for disease progression (41).…”

Section: Multiple Sclerosismentioning

confidence: 99%

The Potential for EBV Vaccines to Prevent Multiple Sclerosis

et al. 2022

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There is increasing evidence suggesting that Epstein-Barr virus infection is a causative factor of multiple sclerosis (MS). Epstein-Barr virus (EBV) is a human herpesvirus, Human Gammaherpesvirus 4. EBV infection shows two peaks: firstly, during early childhood and, secondly during the teenage years. Approximately, 90–95% of adults have been infected with EBV and for many this will have been a subclinical event. EBV infection can be associated with significant morbidity and mortality; for example, primary infection in older children or adults is the leading cause of infectious mononucleosis (IM). A disrupted immune response either iatrogenically induced or through genetic defects can result in lymphoproliferative disease. Finally, EBV is oncogenic and is associated with several malignancies. For these reasons, vaccination to prevent the damaging aspects of EBV infection is an attractive intervention. No EBV vaccines have been licensed and the prophylactic vaccine furthest along in clinical trials contains the major virus glycoprotein gp350. In a phase 2 study, the vaccine reduced the rate of IM by 78% but did not prevent EBV infection. An EBV vaccine to prevent IM in adolescence or young adulthood is the most likely population-based vaccine strategy to be tested and adopted. National registry studies will need to be done to track the incidence of MS in EBV-vaccinated and unvaccinated people to see an effect of the vaccine on MS. Assessment of vaccine efficacy with MS being a delayed consequence of EBV infection with the average age of onset being approximately 30 years of age represents multiple challenges.

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“…This means that in the last 20 years, we have been facing an abundance of diseases that are due to the industrialization or modernization of society, and the incidence of MS is increasing ( 17 , 18 ). The cause of MS is still unknown ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

Toxic Air Pollutants and Their Effect on Multiple Sclerosis: A Review Study

Mohammadi

Zarea

Hatamzadeh

et al. 2022

Front. Public Health

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Toxic air pollutants are one of the main factors that have the effect of synergism to increase the incidence of multiple sclerosis (MS). This review aims to investigate the effects of toxic air pollutants on the occurrence of multiple sclerosis (MS). A narrative review of the literature was done from 2000 to 2022 based on various databases such as Google Scholar, Web of Science, Springer, PubMed, and Science Direct. In this study, according to the databases, three hundred and sixty articles were retrieved. Of these, 28 studies were screened after review and 14 full-text articles entered into the analysis process. Finally, 9 articles were selected in this study. According to the finding of this study, toxic air pollutants including polycyclic aromatic hydrocarbons (PAHs), heavy metals (HM), volatile organic compounds (VOCs), particulate matter (PM), and gases are the main agents that cause the development and spread of chronic diseases such as respiratory and cardiovascular diseases, chronic obstructive pulmonary disease (COPD), and multiple sclerosis. The result of this study showed that the main sources of emission of toxic air pollutants include industries, cars, power plants, and the excessive consumption of fossil fuels. In general, the inhalation of high concentration of toxic air pollutants can increase the risk of chronic diseases and multiple sclerosis.

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Role of environmental factors in multiple sclerosis

Cited by 33 publications

References 216 publications

Increasing incidence and prevalence of multiple sclerosis in the Greater Hobart cohort of Tasmania, Australia

Increasing incidence and prevalence of multiple sclerosis in the Greater Hobart cohort of Tasmania, Australia

The Potential for EBV Vaccines to Prevent Multiple Sclerosis

Toxic Air Pollutants and Their Effect on Multiple Sclerosis: A Review Study

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