TY - JOUR
T1 - The contribution of secondhand tobacco smoke exposure to pediatric multiple sclerosis risk
N1 - Publisher Copyright:
© The Author(s), 2018.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Background: Pediatric acquired demyelinating syndromes (ADSs) are monophasic (mono-ADS) in 70% of cases and represent the first attack of multiple sclerosis (MS) in 30%. Secondhand tobacco smoke (SHS) exposure has been implicated as a risk factor for adult-onset MS. Little is known about whether SHS presents an additive risk beyond genetic factors and other environmental exposures associated with pediatric MS. Methods: This study examined SHS exposure in 216 children with mono-ADS and 81 children with MS. Interactions between SHS, HLA-DRB1*15 alleles, serum 25-hydroxyvitamin D concentrations, and serological evidence of remote Epstein–Barr virus (EBV) exposure were evaluated. Results: SHS exposure was more common in children with MS (37% exposed) compared to mono-ADS (29.5% exposed). Compared to mono-ADS, SHS exposure was not an independent risk factor for MS. When both SHS exposure and HLA-DRB1*15 were present, the odds for MS increased (odds ratio (OR) = 3.7; 95% confidence interval (CI): 1.17–11.9) compared to mono-ADS. Interactions between SHS and vitamin D or EBV did not associate with MS. Conclusion: Exposure to SHS is a risk factor for central nervous system (CNS) demyelination. Results suggest that SHS exposure and HLA-DRB1*15 interact to increase risk for MS in children diagnosed with mono-ADS.
AB - Background: Pediatric acquired demyelinating syndromes (ADSs) are monophasic (mono-ADS) in 70% of cases and represent the first attack of multiple sclerosis (MS) in 30%. Secondhand tobacco smoke (SHS) exposure has been implicated as a risk factor for adult-onset MS. Little is known about whether SHS presents an additive risk beyond genetic factors and other environmental exposures associated with pediatric MS. Methods: This study examined SHS exposure in 216 children with mono-ADS and 81 children with MS. Interactions between SHS, HLA-DRB1*15 alleles, serum 25-hydroxyvitamin D concentrations, and serological evidence of remote Epstein–Barr virus (EBV) exposure were evaluated. Results: SHS exposure was more common in children with MS (37% exposed) compared to mono-ADS (29.5% exposed). Compared to mono-ADS, SHS exposure was not an independent risk factor for MS. When both SHS exposure and HLA-DRB1*15 were present, the odds for MS increased (odds ratio (OR) = 3.7; 95% confidence interval (CI): 1.17–11.9) compared to mono-ADS. Interactions between SHS and vitamin D or EBV did not associate with MS. Conclusion: Exposure to SHS is a risk factor for central nervous system (CNS) demyelination. Results suggest that SHS exposure and HLA-DRB1*15 interact to increase risk for MS in children diagnosed with mono-ADS.
KW - Multiple sclerosis
KW - epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85043345772&partnerID=8YFLogxK
U2 - 10.1177/1352458518757089
DO - 10.1177/1352458518757089
M3 - Article
C2 - 29393768
SN - 1352-4585
VL - 25
SP - 515
EP - 522
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 4
ER -