Examining the contributions of environmental quality to pediatric multiple sclerosis

Amy M. Lavery*, Amy T. Waldman, T. Charles Casper, Shelly Roalstad, Meghan Candee, John Rose, Anita Belman, Bianca Weinstock-Guttman, Greg Aaen, Jan Mendelt Tillema, Moses Rodriguez, Jayne Ness, Yolanda Harris, Jennifer Graves, Lauren Krupp, Leslie Benson, Mark Gorman, Manikum Moodley, Mary Rensel, Manu GoyalSoe Mar, Tanuja Chitnis, Teri Schreiner, Tim Lotze, Benjamin Greenberg, Ilana Kahn, Jennifer Rubin, Emmanuelle Waubant, for the U.S. Network of Pediatric MS Centers

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Background Multiple sclerosis (MS) is a presumed autoimmune disease caused by genetic and environmental factors. It is hypothesized that environmental exposures (such as air and water quality) trigger the innate immune response thereby activating a pro-inflammatory cascade. Objective To examine potential environmental factors in pediatric MS using geographic information systems (GIS). Methods Pediatric MS cases and healthy controls were identified as part of an ongoing multicenter case-control study. Subjects’ geographic locations were mapped by county centroid to compare to an Environmental Quality Index (EQI). The EQI examines 5 individual environmental components (air, land, water, social, built factors). A composite EQI score and individual scores were compared between cases and controls, stratified by median proximity to enrollment centers (residence <20 or ≥20 miles from the recruiting center), using logistic regression. Results Of the 287 MS cases and 445 controls, 46% and 49% respectively live in areas where the total EQI is the highest (worst environmental quality). Total EQI was not significantly associated with the odds for MS (p = 0.90 < 20 miles from center; p = 0.43 ≥ 20 miles); however, worsening air quality significantly impacted the odds for MS in those living near a referral center (OR = 2.83; 95%CI 1.5, 5.4) and those who reside ≥ 20 miles from a referral center (OR = 1.61; 95%CI 1.2, 2.3). Conclusion Among environmental factors, air quality may contribute to the odds of developing MS in a pediatric population. Future studies will examine specific air constituents and other location-based air exposures and explore potential mechanisms for immune activation by these exposures.

Original languageEnglish (US)
Pages (from-to)164-169
Number of pages6
JournalMultiple Sclerosis and Related Disorders
Volume18
DOIs
StatePublished - Nov 2017

Funding

Dr. Waubant is funded by the NIH ( 1R01NS071463 ). Dr. Casper is funded by the National Multiple Sclerosis Society ( HC 0165 ). Dr. Waldman is funded by the NIH ( K23NS069806 ).

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Examining the contributions of environmental quality to pediatric multiple sclerosis'. Together they form a unique fingerprint.

Cite this