Environmental factors in early childhood are associated with multiple sclerosis: a case-control study
Tóm tắt
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS) with increasing incidence mainly in high-income countries. One explanation of this phenomenon may be a higher prevalence of allergic and autoimmune diseases in industrialized countries as a consequence of otherwise beneficial advances in sanitation (hygiene hypothesis). We investigated environmental factors in early childhood associated with MS. A case-control study was performed of 245 MS patients and 296 population-based controls in Berlin. The study participants completed a standardized questionnaire on environmental factors in childhood and youth, including aspects of personal and community hygiene. Multivariable logistic regression analysis was performed to investigate factors in childhood and youth associated with the occurrence of MS. Mean age was 46 years (range, 20-80) in the MS group and 42 years (range 18-80) in the control group, of which 73.9% in the MS and 61.5% in the control group were female. The multivariable analysis showed that having at least two older siblings (OR 0.54; p = 0.05, for individuals with two older siblings compared to individuals without older siblings), attending a day-care center (OR 0.5; p = 0.004) and growing up in an urban center with more than 100, 000 inhabitants (OR 0.43; p = 0.009) were factors independently associated with a lower chance for MS. The hygiene hypothesis may play a role in the occurrence of MS and could explain disease distribution and increasing incidence.
Tài liệu tham khảo
Nicoletti A, Patti F, Lo FS, Messina S, Bruno E, Quattrocchi G, et al: Increasing frequency of multiple sclerosis in Catania, Sicily: a 30-year survey. Mult Scler. 2011, 17: 273-280. 10.1177/1352458510386995.
Granieri E, Economou NT, De GR, Tola MR, Caniatti L, Govoni V, et al: Multiple sclerosis in the province of Ferrara: evidence for an increasing trend. J Neurol. 2007, 254: 1642-1648. 10.1007/s00415-007-0560-5.
Pugliatti M, Riise T, Sotgiu MA, Sotgiu S, Satta WM, Mannu L, et al: Increasing incidence of multiple sclerosis in the province of Sassari, northern Sardinia. Neuroepidemiology. 2005, 25: 129-134. 10.1159/000086677.
Kurtzke JF, Beebe GW, Norman JE: Epidemiology of multiple sclerosis in US veterans: III. Migration and the risk of MS. Neurology. 1985, 35: 672-678.
Hernan MA, Olek MJ, Ascherio A: Geographic variation of MS incidence in two prospective studies of US women. Neurology. 1999, 53: 1711-1718.
Sadovnick AD, Yee IML, Ebers GC: Factors influencing sib risks for multiple sclerosis. Clin Genet. 2000, 58: 431-435.
Ebers GC: Genetic epidemiology of multiple sclerosis. Curr Opin Neurol. 1996, 9: 155-158. 10.1097/00019052-199606000-00002.
Sawcer S, Ban M, Maranian M, Yeo TW, Compston A, Kirby A, et al: A high-density screen for linkage in multiple sclerosis - International multiple sclerosis genetics consortium. Am J Hum Genet. 2005, 77: 454-467.
Thacker EL, Mirzaei F, Ascherio A: Infectious mononucleosis and risk for multiple sclerosis: A meta-analysis. Ann Neurol. 2006, 59: 499-503. 10.1002/ana.20820.
Cantorna MT: Vitamin D and its role in immunology: Multiple sclerosis, and inflammatory bowel disease. Prog Biophys Mol Bio. 2006, 92: 60-64. 10.1016/j.pbiomolbio.2006.02.020.
Kampman MT, Brustad M: Vitamin D: A candidate for the environmental effect in multiple sclerosis - Observations from Norway. Neuroepidemiology. 2008, 30: 140-146. 10.1159/000122330.
Riise T, Nortvedt MW, Ascherio A: Smoking is a risk factor for multiple sclerosis. Neurology. 2003, 61: 1122-11U8.
Mikaeloff Y, Caridade G, Tardieu M, Suissa S: Parental smoking at home and the risk of childhood-onset multiple sclerosis in children. Brain. 2007, 130: 2589-2595. 10.1093/brain/awm198.
Handel AE, Handunnetthi L, Giovannoni G, Ebers GC, Ramagopalan SV: Genetic and environmental factors and the distribution of multiple sclerosis in Europe. Eur J Neurol. 2010, 17: 1210-1214. 10.1111/j.1468-1331.2010.03003.x.
Leibowitz U, Antonovsky A, Medalie JM, Smith HA, Halpern L, Alter M: Epidemiological Study of Multiple Sclerosis in Israel. 2. Multiple Sclerosis and Level of Sanitation. J Neurol Neurosurg Psychiatry. 1966, 29: 60-8. 10.1136/jnnp.29.1.60. 1966
Strachan DP: Hay-Fever, Hygiene, and Household Size. BMJ. 1989, 18 (299): 1259-60.
Fleming JO, Cook TD: Multiple sclerosis and the hygiene hypothesis. Neurology. 2006, 67: 2085-2086. 10.1212/01.wnl.0000247663.40297.2d.
Ponsonby AL, van der Mei I, Dwyer T, Blizzard L, Taylor B, Kemp A, et al: Exposure to infant siblings during early life and risk of multiple sclerosis. JAMA. 2005, 293: 463-469. 10.1001/jama.293.4.463.
Ponsonby AL, Dwyer T, van der Mei I, Kemp A, Blizzard L, Taylor B, et al: Asthma onset prior to multiple sclerosis and the contribution of sibling exposure in early life. Clin Exp Immunol. 2006, 146: 463-470. 10.1111/j.1365-2249.2006.03235.x.
Sadovnick AD, Yee IML, Ebers GC: Multiple sclerosis and birth order: a longitudinal cohort study. Lancet Neurol. 2005, 4: 611-617. 10.1016/S1474-4422(05)70170-8.
Schafer T, Vieluf D, Behrendt H, Kramer U, Ring J: Atopic eczema and other manifestations of atopy: Results of a study in East and West Germany. Allergy. 1996, 51: 532-539.
Tomaszewska A, Raciborski F, Samel-Kowalik P, Samolinski B: Frequency of allergic rhinitis in selected regions of Poland. City vs countryside analysis. Otolaryngol Pol. 2007, 61: 550-553. 10.1016/S0030-6657(07)70482-1.
Eide GE, Gefeller O: Sequential and average attributable fractions as aids in the selection of preventive strategies. J Clin Epidemiol. 1995, 48: 645-655. 10.1016/0895-4356(94)00161-I.
Ruckinger S, von KR, Toschke AM: An illustration of and programs estimating attributable fractions in large scale surveys considering multiple risk factors. BMC Med Res Methodol. 2009, 9: 7-10.1186/1471-2288-9-7.
Pedotti R, Farinotti M, Falcone C, Borgonovo L, Confalonieri P, Campanella A, et al: Allergy and multiple sclerosis: a population-based case-control study. Mult Scler. 2009, 15: 899-906. 10.1177/1352458509106211.
Tremlett HL, Evans J, Wiles CM, Luscombe DK: Asthma and multiple sclerosis: an inverse association in a case-control general practice population. QJM. 2002, 95: 753-756. 10.1093/qjmed/95.11.753.
Zekveld C, Bibakis I, Bibaki-Liakou V, Pedioti A, Dimitroulis I, Harris J, et al: The effects of farming and birth order on asthma and allergies. Eur Respir J. 2006, 28: 82-88. 10.1183/09031936.06.00021305.
Gaudet JP, Hashimoto L, Sadovnick AD, Ebers GC: Is sporadic MS caused by an infection of adolescence and early adulthood? A case-control study of birth order position. Acta Neurol Scand. 1995, 91: 19-21.
Ahlgren C, Andersen O: No major birth order effect on the risk of multiple sclerosis. Neuroepidemiology. 2005, 24: 38-41. 10.1159/000081048.
Gaudet JP, Hashimoto L, Sadovnick AD, Ebers GC: A study of birth order and multiple sclerosis in multiplex families. Neuroepidemiology. 1995, 14: 188-192. 10.1159/000109795.
Ascherio A, Munger KL, Lennette ET, Spiegelman D, Hernan MA, Olek MJ, et al: Epstein-Barr virus antibodies and risk of multiple sclerosis: a prospective study. JAMA. 2001, 286: 3083-3088. 10.1001/jama.286.24.3083.
Haahr S, Koch-Henriksen N, Moller-Larsen A, Eriksen LS, Andersen HM: Increased risk of multiple sclerosis after late Epstein-Barr virus infection: a historical prospective study. Mult Scler. 1995, 1: 73-77.
Levin LI, Munger KL, Rubertone MV, Peck CA, Lennette ET, Spiegelman D, et al: Multiple sclerosis and Epstein-Barr virus. JAMA. 2003, 289: 1533-1536. 10.1001/jama.289.12.1533.
Beebe GW, Kurtzke JF, Kurland LT, Auth TL, Nagler B: Studies on the natural history of multiple sclerosis. 3. Epidemiologic analysis of the army experience in World War II. Neurology. 1967, 17: 1-17.
Fromont A, Binquet C, Sauleau EA, Fournel I, Bellisario A, Adnet J, et al: Geographic variations of multiple sclerosis in France. Brain. 2010, 133: 1889-1899. 10.1093/brain/awq134.
Sospedra M, Martin R: Immunology of multiple sclerosis. Annu Rev Immunol. 2005, 23: 683-747. 10.1146/annurev.immunol.23.021704.115707.
D'Amato G, Cecchi L, D'Amato M, Liccardi G: Urban air pollution and climate change as environmental risk factors of respiratory allergy: an update. J Investig Allergol Clin Immunol. 2010, 20: 95-102.
Iversen L, Hannaford PC, Price DB, Godden DJ: Is living in a rural area good for your respiratory health? Results from a cross-sectional study in Scotland. Chest. 2005, 128: 2059-2067. 10.1378/chest.128.4.2059.
The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2377/11/123/prepub