Article

Relationship of UV exposure to prevalence of multiple sclerosis in England

Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.
Neurology (Impact Factor: 8.29). 04/2011; 76(16):1410-4. DOI: 10.1212/WNL.0b013e318216715e
Source: PubMed

ABSTRACT

To assess the potential relationship of ultraviolet B radiation (UVB) and Epstein-Barr virus (EBV) exposure in explaining the period prevalence of multiple sclerosis (MS) in England.
English national Hospital Episode Statistics covering all admissions to National Health Service hospitals in England in the 7 years from 1998 to 2005 were used to obtain the period prevalences of MS and infectious mononucleosis (IM) in England. The United States National Aeronautics and Space Administration's data on UVB intensity for England from the Nimbus 7 satellite was collected. The relationships among the 3 variables (MS prevalence, IM prevalence, and UVB intensity) were investigated.
The regression of MS against UVB intensity for all seasons had an r(2) of 0.61; when including the interaction of IM with seasonal UVB, the r(2) rose to 0.72.
UVB exposure and IM together can explain a substantial proportion of the variance of MS. The effect of UVB on generating vitamin D seems the most likely candidate for explaining its relationship with MS. There is a pressing need to investigate the role of vitamin D and EBV and how they might interact to influence MS risk to identify potential prevention strategies.

    • "hites. In England and Wales, immigrant non-Caucasian ethnic groups have historically concentrated in cities where, as already noted, radon levels are generally low (Bands 0 and 1), where the 50-measurement criterion excludes many postcode sectors from analysis (Band 0), and where genetic disposition to MS is below average (Hedstr€ om et al., 2013).Ramagopalan et al. (2011)observe that the pattern of UV-B and MS is confounded in large metropolitan areas (Merseyside, Manchester, Leeds, Birmingham and London), geographicallyweighted regression showing these regions to be two standard deviations below the main trend. The Database Managers report (Blak et al., 2011) that THIN has a higher proportion of patient"
    [Show abstract] [Hide abstract]
    ABSTRACT: To test whether an association exists between radon gas concentration in the home and increased multiple sclerosis (MS) incidence, a retrospective study was undertaken of MS incidence in known areas of raised domestic radon concentration in England and Wales, using The Health Improvement Network (THIN) clinical research database. The study population comprised 20,140,498 person-years of clinical monitoring (males: 10,056,628: 49.93%; females: 10,083,870: 50.07%), representing a mean annual population of 2.5 million individuals. To allow for the possible latency of MS initiation following exposure, data extraction was limited to patients with at least five years registration history with the same GP practice before first diagnosis. Patient records were allocated to one of nine radon concentration bands depending on the average radon level in their postcode sector. MS incidence was analysed by searching for patients with first MS diagnosis over the eight calendar years 2005-2012 inclusive. 1512 new MS cases were diagnosed, 1070 females, 442 males, equivalent to raw incidence rates of 7.51, 10.61 and 4.40 per 105 person-years respectively, comparable to previously reported results. Of these new cases, 115 could be allocated to one of the radon bands representing high radon areas. Standardising to the UK 2010 population, excess relative risk (ERR) figures for MS were calculated for each radon band. Linear regression of ERR against mean band radon concentration shows a positive gradient of 0.22 per 100 Bq$m�3 (R2 ¼ 0.25, p ¼ 0.0961) when forced through the origin to represent a linear-no-threshold response. The null hypothesis falls inside the 95% confidence interval for the linear fit and therefore this fit is not statistically significant. We conclude that, despite THIN sampling around 5% of the population, insufficient data was available to confirm or refute the hypothesised association between MS incidence and radon concentration.
    No preview · Article · Jan 2016 · Journal of Environmental Radioactivity
  • Source
    • "leosis distribute similarly and it has been shown that MS risk increases tenfold in patients infected with EBV during childhood=teenage years , when compared to populations of EBV - seronegatives ( Ascherio and Munger , 2007 ) . Interestingly , the risk of developing MS increases if low levels of vitamin D and EBV exposure occur concomi - tantly ( Ramagopalan et al . , 2011 ) . MS is considered a T - cell – mediated disease in which CD4 T helper ( Th ) cells of the Th17 and Th1 phenotype play a fundamental role in its pathogenesis ( Kebir et al . , 2009 ) . B cells are also essential in MS immunopathogenesis , as antibodies produced intrathecally are a fundamental feature of the disease ( i . e . oligoclon"
    [Show abstract] [Hide abstract]
    ABSTRACT: The Blood Brain Barrier (BBB) is a specialized vascular structure tightly regulating central nervous system (CNS) homeostasis. Endothelial cells are the central component of the BBB and control of their barrier phenotype resides on astrocytes and pericytes. Interactions between these cells and the endothelium promote and maintain many of the physiological and metabolic characteristics that are unique to the BBB. In this review we describe recent findings related to the involvement of astroglial cells, including radial glial cells, in the induction of barrier properties during embryogenesis and adulthood. In addition, we describe changes that occur in astrocytes and endothelial cells during injury and inflammation with a particular emphasis on alterations of the BBB phenotype. GLIA 2013.
    Full-text · Article · Dec 2013 · Glia
  • Source
    • "Average monthly UVB radiation at the wavelength of 305 nm at noon (joules/square metre) in England and Scotland between 1979 and 1992 was obtained from the National Aeronautics and Space Administration's Total Ozone Mapping Program on the Nimbus 7 satellite, as previously described [27]. Average monthly 25-OH-D levels were collected from a large cohort of adult Scottish and English women (n = 3,787) as previously described [28] and used as a proxy for the seasonal variation in gestational vitamin D status. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background A season of birth effect in immune-mediated diseases (ID) such as multiple sclerosis and type 1 diabetes has been consistently reported. We aimed to investigate whether season of birth influences the risk of rheumatoid arthritis, Crohn's disease, ulcerative colitis and systemic lupus erythematosus in addition to multiple sclerosis, and to explore the correlation between the risk of ID and predicted ultraviolet B (UVB) light exposure and vitamin D status during gestation. Methods The monthly distribution of births of patients with ID from the UK (n = 115,172) was compared to that of the general population using the Cosinor test. Predicted UVB radiation and vitamin D status in different time windows during pregnancy were calculated for each month of birth and correlated with risk of ID using the Spearman's correlation coefficient. Results The distributions of ID births significantly differed from that of the general population (P = 5e-12) with a peak in April (odds ratio = 1.045, 95% confidence interval = 1.024, 1.067, P < 0.0001) and a trough in October (odds ratio = 0.945, 95% confidence interval = 0.925, 0.966, P < 0.0001). Stratification by disease subtype showed seasonality in all ID but Crohn's disease. The risk of ID was inversely correlated with predicted second trimester UVB exposure (Spearman's rho = -0.49, P = 0.00005) and third trimester vitamin D status (Spearman's rho = -0.44, P = 0.0003). Conclusions The risk of different ID in the UK is significantly influenced by the season of birth, suggesting the presence of a shared seasonal risk factor or factors predisposing to ID. Gestational UVB and vitamin D exposure may be implicated in the aetiology of ID.
    Full-text · Article · Jul 2012 · BMC Medicine
Show more