Evaluating the association of allergies with multiple sclerosis susceptibility risk and disease activity in a pediatric population

Abstract

Background Multiple sclerosis (MS) and allergies are both considered to be related to imbalanced Th1 and Th2 immune responses. Previous studies evaluating the relationship between MS and allergies provide conflicting results. Objective To assess allergies and asthma as risk factors for MS and as predictors of MS relapses in a pediatric cohort. Methods The environment and genetic risk factors for pediatric MS study is a national case-control project with 16 participating US sites. An environmental questionnaire is used that includes history of allergies in the first five years of life. Case-control data are entered in the pediatric MS Network database and cases at 12 of the 16 sites enter relapse data prospectively. Annualized relapse rate was calculated for patients with follow-up and adjusted for age at disease onset, gender, race, ethnicity, and use of disease-modifying therapy (DMT). Results We included 271 cases (mean age at disease onset of 15.7 years and 62% female) and 418 controls. Relapse data were available for 193 cases. There was no difference in prevalence of allergies or asthma between cases and controls. Patients with food allergies had fewer relapses compared to patients without food allergies (.14 vs .48, p = .01). Conclusions While allergies and asthma are not associated with pediatric MS, cases with food allergies have fewer relapses compared to those without food allergies.

Food allergies are associated with increased disease activity in multiple sclerosis

“…A previous case-control study analysed the association between allergy history and relapse rate in a paediatric MS cohort. Their findings suggested that food allergies in the first 5 years of life had a lower ARR compared with patients without food allergies (0.14 vs 0.48, P=0.01), with no association found between relapse rate and other types of allergies 10. These findings contrast with our results which showed a higher attack rate in adult MS patients who reported food allergy.…”

“…To our knowledge, no studies have addressed this question in an adult MS population. A case-control study from 16 centres across the USA studied the association between allergy history and relapse rate in a paediatric MS population, and reported that patients with food allergies in the first 5 years of life had a lower absolute relapse rate (ARR) compared with patients without comorbid food allergies (0.14 vs 0.48, P=0.01), and found no association between relapse rate and other types of allergies 10. The aim of our study was to assess the association between a self-reported history of allergic conditions with MS clinical and MRI disease activity in adults.…”

Paediatric asthma and non‐allergic comorbidities: A review of current risk and proposed mechanisms

“…138 The researchers found a non-significant risk of celiac disease in children with doctor-diagnosed asthma (OR 1.4, 95% CI 0.8, 2.5) that increased when applying an asthma definition based on family history of asthma (Asthma Predictive Index OR 2.8, 95% CI 1.3, 6.0), concluding that differences in asthma comorbidity risks may reflect different asthma phenotypes. Juvenile idiopathic arthritis 139 and psoriasis 140 were also found to be comorbid with asthma in single studies, but not multiple sclerosis, 141 which is in line with findings in adults. 142…”

Food allergies and multiple sclerosis

“…The findings of Fakih et al are in the opposite direction with a previous report showing an inverse association between self-reported food allergies and disease activity in a paediatric population with MS 4. Several factors could have accounted for divergent findings.…”