There are many things about MS that we still do not know, but arguably the most important of these is cause. Pinning down the cause of MS has been a top priority amongst MS researchers for decades and, despite a growing body of promising evidence, the question of cause remains unresolved.
What we are learning more about are the ‘triggers of MS’, which are factors that may be contributing in one way or another to the development of disease. I already mentioned in a previous post that gender has a lot to do with MS susceptibility and severity, and recently the MS Scientific Research Foundation – an MS Society affiliated research funder – launched an extensive, multi-year study that identified different genetic and lifestyle factors which were found to be associated with MS. The study, led by Professor George Ebers who is pictured above, uncovered several important insights about MS triggers (read examples here and here).
ECTRIMS was a great platform to discuss the newest data on MS triggers. It was clear from the lectures that we are moving closer to understanding how genes, lifestyle habits, geographic location and environmental surroundings can impact one’s risk of MS. Here are some of the interesting things I heard at the conference.
Smoking – A Swedish research group led by Dr. Lars Alfredsson reported that smokers have a 50% increase in risk of MS. They added that risk of MS does not depend on the age at which a person began smoking, however the more they smoke the greater the risk.
Sodium (Salt) – Dr. Mauricio Farez from Argentina measured the amount of sodium in people with MS over a two year period. Results of the study demonstrated that increased sodium intake correlates with higher relapse rates and greater number of lesions on MRI. This research began following an earlier study showing that salt intake was associated with vitamin D levels and body mass index, and in light of recent studies reporting a link between vitamin D and MS risk, Dr. Farez found it logical to further explore the role of salt in MS.
Viruses – Most research on viruses in MS has focused on the Epstein–Barr virus (EBV), which is a common childhood virus that has been considered a possible trigger of MS. Interesting new evidence presented by Dr. Julian Gold showed a relationship between human retroviruses and MS. These types of viruses can hide their genetic material into the DNA of its host, making it harder to detect and easy for the virus to replicate. Dr. Gold reported that that in patients with HIV – a type of retrovirus – the use of effective anti-viral therapies has co-incidentally also treated those patients who should have developed MS.
Vitamin D – Dr. Alberto Ascherio from Boston presented on the role of vitamin D in predicting disease activity and prognosis in people with early signs of MS. He and his colleagues found that in MS patients treated with interferon therapy, low vitamin D levels were a strong risk-factor for long-term MS activity and severity. Conversely, higher vitamin D levels predicted slower conversion to MS, reduced MS activity, and slower rate of progression. They conclude that this research makes a strong case for vitamin D supplementation in early treatment of MS.
I also came across an interesting post on MS triggers from MS Village Canada. The post describes a recently published article that looks at the potential role of bacteria in MS. Read more about the study here.
As you can see, understanding the biological as well as outside influences on MS disease is a very active area of research. As scientists come up with more effective ways ways of collecting, analyzing, and disseminating data I am hopeful that this research will lead to improved screening for people who are at high risk of MS, better management of disease, and a definitive answer to the question what causes multiple sclerosis?