The contribution of secondhand tobacco smoke exposure to pediatric multiple sclerosis risk.
Mult Scler
; 25(4): 515-522, 2019 04.
Article
in En
| MEDLINE
| ID: mdl-29393768
ABSTRACT
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.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tobacco Smoke Pollution
/
Demyelinating Diseases
/
HLA-DRB1 Chains
/
Gene-Environment Interaction
/
Multiple Sclerosis
Type of study:
Etiology_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
America do norte
Language:
En
Journal:
Mult Scler
Journal subject:
NEUROLOGIA
Year:
2019
Document type:
Article
Affiliation country:
United States