A systematic review of the incidence and prevalence of autoimmune disease in multiple sclerosis

Abstract

Background:As new therapies emerge which increase the risk of autoimmune disease it is increasingly important to understand the incidence of autoimmune disease in multiple sclerosis (MS).Objective:The purpose of this review is to estimate the incidence and prevalence of comorbid autoimmune disease in MS.Methods:The PUBMED, EMBASE, SCOPUS and Web of Knowledge databases, conference proceedings, and reference lists of retrieved articles were searched, and abstracts were independently screened by two reviewers. The data were abstracted by one reviewer using a standardized data collection form, and the findings were verified by a second reviewer. We assessed quality of the included studies using a standardized approach and conducted meta-analyses of population-based studies.Results:Sixty-one articles met the inclusion criteria. We observed substantial heterogeneity with respect to the populations studied, methods of ascertaining comorbidity, and reporting of findings. Based solely on population-based studies, the most prevalent autoimmune comorbidities were psoriasis (7.74%) and thyroid disease (6.44%). Our findings also suggest an increased risk of inflammatory bowel disease, likely uveitis and possibly pemphigoid.Conclusion:Fewer than half of the studies identified were of high quality. Population-based studies that report age, sex and ethnicity-specific estimates of incidence and prevalence are needed in jurisdictions worldwide.

Depression in Autoimmune Diseases

“…We will concentrate on systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), since in these diseases large cohort studies on mental health have been conducted and therefore a relatively amount of data are available. However, depression-like symptoms have also been well described in many other autoimmune diseases including multiple sclerosis and inflammatory bowel disease (for review see (Greenley et al, 2010;Marrie et al, 2015)). Moreover, depression-like symptoms are also a hallmark of autoinflammatory diseases.…”

Autoimmune Comorbidities Are Associated with Brain Injury in Multiple Sclerosis

“…[5][6][7][8][9][10][11][12][13][14] Examples of the most frequent comorbidities or secondary disorders that co-occur with MS include thyroid disease, rheumatoid arthritis, psoriasis, cardiovascular disorders, depression and anxiety, diabetes mellitus, chronic lung disease, and irritable bowel syndrome, among others. [4][5][6][8][9][10]14,15 The pathogenesis of these associations with MS is unclear at this time but may be linked to a genetic predisposi-tion, 5,16,17 the presence of a chronic inflammatory condition, 10 environmental factors, 18 and the use of disease-modifying therapy. 19 It has been postulated that CD4ϩ T-cells of the Th1 phenotype, CD8ϩ T-cells, and B-cells play a key role in focal and diffuse destruction of the CNS in patients with MS. 20 The immune deviation of CD 4ϩ T-cells into Th1 and Th2 phenotypes has been the subject of many immunologic and epidemiologic studies in MS. 21,22 In particular, it has been reported that Th1 responses associated with autoimmunity may be attenuated by a Th2 shift.…”

Neurological Manifestations of Inflammatory Bowel Disease

“…Rang et al described a higher prevalence of multiple sclerosis (MS) than expected in UC patients [33]. Subsequently, this inding has been conirmed by many reports, but not only for UC but also for CD [34][35][36]. For instance, Gupta et al described an increased risk of optic neuritis and other forms of MS in CD (odds ratio = 1.54) and UC (odds ratio = 1.75) [35].…”