Multiple sclerosis risk factors include vitamin D

Created December 2016

Interactions between genetic, lifestyle and environmental risk factors for multiple sclerosis.

Nat Rev Neurol. 2016 Dec 9. doi: 10.1038/nrneurol.2016.187. [Epub ahead of print]

Olsson T1, Barcellos LF2, Alfredsson L3.

1Neuroimmunology Unit, Center for Molecular Medicine, L8:04, Karolinska University Hospital (Solna), 17176 Stockholm, Sweden.

2Genetic Epidemiology and Genomics Laboratory, California Institute for Quantitative Biosciences (QB3), Office: 308D Stanley Hall, University of California, Berkeley, CA 94720-3220.

3Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77 Stockholm, Sweden.

* Multiple Sclerosis risk factors – Vitamin D, parasites, and EBV – 2015 * Environmental risk factors for MS include latitude and vitamin D – Sept 2012 * Lack of sun and lack of vitamin D are both MS risk factors – Feb 2011 * Overview MS and vitamin D MS updates from Brazil {include} Multiple Sclerosis and (lots of) Vitamin D - book by patient on Coimbra protocol - Feb 2016 contains protocol description {include}

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Genetic predisposition to multiple sclerosis (MS) only explains a fraction of the disease risk; lifestyle and environmental factors are key contributors to the risk of MS. Importantly, these nongenetic factors can influence pathogenetic pathways, and some of them can be modified. Besides established MS-associated risk factors –

  • high latitude,

  • female sex,

  • smoking,

  • low vitamin D levels

    • caused by insufficient sun exposure and/or dietary intake, and
  • Epstein-Barr virus (EBV) infection
      • strong evidence now supports obesity during adolescence as a factor increasing MS risk.

  • Organic solvents and shift work have also been reported to confer increased risk of the disease,

whereas factors such as

  • use of nicotine or alcohol,

  • cytomegalovirus infection and a

  • high coffee consumption

are associated with a reduced risk .

Certain factors - smoking, EBV infection and obesity - interact with HLA risk genes, pointing at a pathogenetic pathway involving adaptive immunity. All of the described risk factors for MS can influence adaptive and/or innate immunity, which is thought to be the main pathway modulated by MS risk alleles. Unlike genetic risk factors, many environmental and lifestyle factors can be modified, with potential for prevention, particularly for people at the greatest risk, such as relatives of individuals with MS. Here, we review recent data on environmental and lifestyle factors, with a focus on gene-environment interactions.

PMID: 27934854 DOI: 10.1038/nrneurol.2016.187

Tags: Multiple Sclerosis