Multiple Sclerosis: Risk Factors and their Interactions
Multiple Sclerosis: Risk Factors and their Interactions
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DOI：
10.2174/187152712801661266
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发表时间：
2012-08-01
影响因子：
3
通讯作者：
Ramagopalan, Sreeram V.
中科院分区：
文献类型：
--
作者：
Disanto, Giulio;Morahan, Julia M.;Ramagopalan, Sreeram V.
多发性硬化症(MS)是一种高度衰弱的中枢神经系统免疫调节疾病，对发达国家来说是一个沉重的负担。尽管最近多发性硬化症的研究取得了进展，但哪些危险因素以及它们如何参与多发性硬化症的发病机制在很大程度上是未知的。然而，与研究这种复杂疾病的遗传和地理流行病学的早期研究一致，最近的研究强调了多发性硬化症是如何由遗传易感性和从怀孕到成年早期的环境暴露相结合而产生的。维生素D缺乏、出生季节、Epstein Barr病毒感染和吸烟行为与MS的遗传易感性有很强的相关性，并且能够影响MS的遗传易感性。此外，这些因素似乎是协同作用的，暴露于多种因素的个人患MS的风险是乘性结合的。目前的证据表明，很大一部分多发性硬化症是可以预防的，了解危险因素在生命中如何以及何时起作用最终将有助于制定预防策略。
Multiple sclerosis (MS) is a highly debilitating immune mediated disorder of the central nervous system and represents a substantial burden to the developed world. Despite the recent advances in MS research, which risk factors are implicated and how they contribute to MS pathogenesis is largely unknown. However, in line with older studies investigating the genetic and geographical epidemiology of this complex disease, more recent studies have highlighted how MS arises from a combination of genetic susceptibility and environmental exposures acting from gestation to early adulthood. Vitamin D deficiency, season of birth, Epstein Barr virus infection, and smoking behaviour are strongly implicated and able to influence genetic predisposition to MS. Furthermore, these factors appear to act synergistically and the risk of MS in individuals exposed to more than one factor combines multiplicatively. Current evidence suggests that a large part of MS could be prevented and understanding how and when during life risk factors act will ultimately aid the development of prevention strategies.