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Environmental factors


Alcohol consumption linked to lower MS disability(24/4/15)

Multiple sclerosis patients who consumed larger amounts of alcohol had lower rates of disability per the Expanded Disability Status Score (EDSS) and Multiple Sclerosis Severity Score (MSSS), a new study indicates.

Consumption of beer also affected EDSS scores positively; however consumption of wine had no association with EDSS score, according to Camilio Diaz-Cruz, MD, of Brigham and Women's Hospital in Boston, who reported the findings at the American Academy of Neurology 2015 Annual Meeting.

Camilio and colleagues measured alcohol/wine consumption in servings per week for 908 patients enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis (CLIMB) study. Drinking habits were also assessed, and influence of alcohol or wine consumption on clinical outcomes was assessed using regression models for relapse rate in the past year, and concurrent EDSS and MSSS outcomes. Associations with and changes in Symbol Digit Modality Tests (SDMT) were also assessed in a subset of patients.

There were 56 nondrinkers in the cohort; 98 of who preferred spirits, 249 preferred beer, 283 preferred red wine, and 222 favoured white wine. Median alcohol intake was 1.1 servings per week.

Those who had higher alcohol intake were significantly associated with lower EDSS and MSSS. Both red and white wine had a non-significant negative association with both EDSS and MSSS, and there was no significant association between alcohol or wine consumption and relapse rate in the past year, change in EDSS or MSSS over one year, current SDMT score, and change in SDMT score in the last year. Notably, beer drinkers tended to have lower EDSS, however the relationship was weaker compared to that of “hard liquor”.

Although further data analyses are required to better understand the potential cause-effect relationship and underlying mechanism, the findings are complimentary to several previous but unconfirmed studies that suggest alcohol may be neuroprotective in the risk of developing multiple sclerosis.

Source: Neurology Advisor Copyright © 2015 Haymarket Media, Inc (24/4/15)

Smoking ‘leads to multiple sclerosis treatment issues’(22/04/15)

According to study results presented at the 2015 annual meeting of the American Academy of Neurology in Washington, DC, researchers say they have tied the effects of cigarette smoke with various health issues experienced by current and potential multiple sclerosis patients.

“In previous studies we demonstrated that rats exposed to cigarette smoke develop increased brain inflammation and oxidative stress,” lead author Walter Royal III, MD, and colleagues wrote in the presentation. “In these studies we examine the effects of cigarette smoke exposure on systemic and brain inflammatory responses in a murine model of MS, experimental allergic encephalomyelitis (EAE).”

The team analysed female mice under different conditions by splitting them up into one of the following groups:

Exposed to the smoke chamber but not cigarette smoke or induced to get EAE
Exposed to cigarette smoke but not induced to get EAE
Not exposed to cigarette smoke but induced to get EAE
Exposed to cigarette smoke and induced to get EAE
Not exposed to cigarette smoke or the smoking chamber (controlled group)

For the mice that were exposed to cigarette smoke (5 days per week for 4 weeks) the cigarettes contained the “regular” amount of nicotine (0.7 mg per stick and tar (9.4 mg per stick). Also, they were restrained and ventilated by the smoke machine. The mice were immunized with oligodendrocyte glycoprotein peptide fragment after one month of cigarette smoke exposure and after an additional two weeks their brains were removed for further evaluation.

The authors noted that the control group was under the same restraints but without the smoke.

From this examination the team found that in the mice induced to develop EAE, the ones who were also exposed to cigarette smoke had “significantly enhanced pro-inflammatory response, with increased levels of immune cell activation and cytokine secretion.” The smoke was associated with higher oxidative stress, as previous studies have suggested, and lower expression of Nrf2 as well. The researchers pointed out that in the mice with EAE exposed to cigarette smoke, the nuclear translocation of the transcription factor climbed.

“Such effects may contribute to the development of enhanced disease activity among individuals with MS, and, therefore, studies of the mechanisms and potential treatment of these effects are required the authors wrote.

The study authors concluded that cigarette smoke increases the risk of developing the disease while also making it more likely that treatment will fail.

Source: MD All Specialities Copyright HCPLive 2006-2015 Intellisphere, LLC (22/04/15)

Toxin from tobacco smoke could increase pain in spinal cord injury and worsen MS(05/12/14)

A neurotoxin called acrolein found in tobacco smoke that is thought to increase pain in people with spinal cord injury has now been shown to accumulate in mice exposed to the equivalent of 12 cigarettes daily over a short time period.

One implication is that if acrolein is exacerbating pain its concentration in the body could be reduced using the drug hydralazine, which has been approved by the U.S. Food and Drug Administration for hypertension, said Riyi Shi (pronounced Ree Shee), a professor in Purdue University's Department of Basic Medical Sciences, College of Veterinary Medicine, and Weldon School of Biomedical Engineering.

The drug has been shown to be effective in reducing acrolein levels in research animals, and Shi is working to develop a low-dose version for that purpose in humans.

Mice were exposed to a level of acrolein equivalent to 12 cigarettes per day over three weeks. Previous research has focused on acrolein accumulation in the respiratory system but not in the bloodstream and spinal cord. It is known that acrolein is accumulated in urine in human smokers after years of smoking.

"This is the first animal study demonstrating that an acute short term of weeks of smoking could also cause acrolein to accumulate in urine and more importantly in spinal cord tissue, a part of central nervous system known to be vulnerable to acrolein, he said.

The researchers documented the concentration of biochemical markers for acrolein in the urine and spinal cord. Findings, appearing this week in the journal Neuroscience Bulletin, indicate the accumulation of the toxin was about 50 percent higher than normal, a level known to have pathological implications.

"The data indicated that acrolein is absorbed into the circulatory system and some enters the nervous system," Shi said. "It is expected that these findings may facilitate further studies to probe the pathological role of acrolein in the nervous system resulting from smoke and other external sources through long and short term, both active and passive exposure."

The research paper was authored by Melissa Tully, a graduate student at Purdue and the Indiana University School of Medicine; Purdue graduate students Lingxing Zheng, Glen Acosta, and Ran Tian; and Shi.

Acrolein is produced within the body after nerve cells are damaged. In spinal cord injury and in multiple sclerosis, the myelin insulation surrounding nerve cells is destroyed and the nerve fibers themselves are damaged by acrolein. The toxin acrolein also is found in air pollutants including tobacco smoke and auto exhaust.

"It is already known that smoking can increase pain for people with spinal cord injury and worsen the condition of multiple sclerosis, but we don't know exactly why," Shi said. "I am saying that acrolein might be the key culprit here and that inhaled acrolein could intensify multiple sclerosis and increase pain sensation."

The research is ongoing and was funded by the Indiana State Department of Health, the National Institutes of Health, and an Indiana CTSI CBR/CTR Pilot Program Grant.

Source: Purdue University © 2014 Purdue University (05/12/14)

Could alcohol reduce the risk of getting MS?(21/11/14)

A study by Dr. Anna Karin Hedström and a team of researchers from Sweden's Karolinska Intstitute have discovered a possible link between alcohol consumption and a reduction in the risk of having multiple sclerosis, the degenerative disease of the central nervous system.

According to the abstract of the study published in the Journal of the American Medical Association, the researchers' goal was to “investigate the possible association of alcohol consumption with the risk of developing MS and to relate the influence of alcohol to the effect of smoking.”

The team conducted two case-control studies in which researchers followed more than 6,500 participants from Sweden aged between 16 and 70 years old. The studies took place from April 2005 to November 2011.

In an interview with medical website Medscape, Hedström said the researchers conducted the large-scale study because previous research showed alcohol can have an anti-inflammatory effect.

“The current case-control studies are the largest to look at this association. We wanted to study this as experimental studies and clinical observations have suggested that alcohol has an effect on the immune system and may have anti-inflammatory actions,” she said in the interview. “As MS is an inflammatory condition, we thought alcohol may have a protective effect.”

The results of the test showed a 50 percent reduction in the risk of MS for frequent alcohol drinkers.

The study defined frequent drinkers as men who drank 14 drinks a week and women who drank 9 drinks a week. According to a press release by the National Multiple Sclerosis Society, the results of Hedström's research conflict with earlier studies done by the Harvard School of Public Health (HSPH).

“In a previous study, researchers at (HSPH) examined the association between alcohol and caffeine intake and risk of developing MS in two large groups of women and found no connection between either and the development of MS,” the release stated.

The results of the Karolinska study, however, are encouraging, the society said in the release.

“Unlike a previous study in MS, this study shows some evidence that alcohol consumption is associated with a decrease risk of developing MS,” the release said.

The study did not observe the effect of alcohol on patients who already have MS, Hedström said in her Medscape interview.

“We didn't look at patients who already had MS, so we cannot make firm recommendations on this, but previous research has shown an anti-inflammatory effect of moderate intake,” she said. “I would say that if an MS patient wants to drink alcohol that is absolutely fine.”

Her recommendation comes with the implicit rule that patients should consult their doctors before making a lifestyle change of this sort.

As for MS patients who are concerned about their children's risk for having MS, Hedström say her team's findings aren't a license to begin heavy drinking.

“Whilst we wouldn't recommend them drinking large quantities of alcohol because of other negative consequences, we can probably say that alcohol in moderation will not increase risk and may reduce it somewhat,” she told Medscape. “So I wouldn't advise people to start drinking alcohol specifically to reduce their risk of developing MS, but I would say that you don't need to avoid alcohol or stop drinking alcohol.”

Source: Snooth Copyright © 2014 Snooth, Inc (21/11/14)

Environmental exposures and the risk of multiple sclerosis(03/10/14)

Environmental exposures and the risk of multiple sclerosis Several environmental exposures, including infection with Epstein-Barr virus, low levels of vitamin D and smoking are established risk factors for multiple sclerosis (MS). Also, high hygienic standard and infection with parasites have been proposed to influence MS risk.

The aim of this study was to investigate the influence of various environmental exposures on MS risk in a Norwegian cohort, focusing on factors during childhood related to the hygiene hypothesis.

Methods: A questionnaire concerning environmental exposures, lifestyle, demographics and comorbidity was administrated to 756 Norwegian MS patients and 1090 healthy controls. Logistic regression was used to calculate odds ratio (OR) with 95% confidence interval (CI) for the risk of MS associated with the variables infectious mononucleosis, severe infection during childhood, vaccination and animals in the household during childhood.

Age, gender, HLA-DRB1*15:01, smoking and infectious mononucleosis were included as covariates. General environmental exposures, including tobacco use, were also evaluated.

Results: Infectious mononucleosis was confirmed to be significantly associated with increased MS risk, also after adjusting for the covariates (OR?=?1.79, 95% CI: 1.12-2.87, p?=?0.016).

The controls more often reported growing up with a cat and/or a dog in the household, and this was significant for ownership of cat also after adjusting for the covariates (OR?=?0.56, 95% CI: 0.40-0.78, p?=?0.001). More patients than controls reported smoking and fewer patients reported snuff use.

Conclusions: In this Norwegian MS case control study of environmental exposures, we replicate that infectious mononucleosis and smoking are associated with increased MS risk.

Our data also indicate a protective effect on MS of exposure to cats during childhood, in accordance with the hypothesis that risk of autoimmune diseases like MS may increase with high hygienic standard.

Author: Marte GustavsenChristian PageStine MoenAnja BjølgerudPål Berg-HansenGro NygaardLeiv SandvikBenedicte LieElisabeth CeliusHanne F Harbo

Credits/Source: BMC Neurology 2014, 14:196

Source: 7thSpace Interactive © 2014 7thSpace Interactive (03/10/14)