Multiple sclerosis and immunological-related risk factors: Results from a case-control study

Eftekharian, Mohammad Mahdi; Mousavi, M; Hormoz, Mona Bahmani; Roshanaei, Ghodratollah; Mazdeh, Mehrdokht

doi:10.3233/hab-150281

“…Additionally, no increased risk was seen for vaccination against tetanus and influenza as well (51). Similarly, other class II case-control studies did not report on an increased risk for MS after hepatitis B vaccination (52–54). An even decreased risk for MS was reported after tetanus immunization (8).…”

Section: Basic Immunology Of Vaccinationmentioning

confidence: 93%

Vaccination in Multiple Sclerosis: Friend or Foe?

Zrzavy

¹

,

Kollaritsch

²

,

Rommer

³

et al. 2019

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Multiple sclerosis (MS) is a debilitating disease of the central nervous systems (CNS). Disease-modifying treatments (including immunosuppressive treatments) have shown positive effects on the disease course, but are associated with systemic consequences on the immune system and may increase the risk of infections and alter vaccine efficiency. Therefore, vaccination of MS patients is of major interest. Over the last years, vaccine hesitancy has steadily grown especially in Western countries, partly due to fear of sequelae arising from vaccination, especially neurological disorders. The interaction of vaccination and MS has been discussed for decades. In this review, we highlight the immunology of vaccination, provide a review of literature and discuss the clinical consideration of MS, vaccination and immunosuppression. In conclusion, there is consensus that MS cannot be caused by vaccines, neither by inactivated nor by live vaccines. However, particular attention should be paid to two aspects: First, in immunocompromised patients, live vaccines may lead to a stronger immune reaction with signs of the disease against which the patients have been vaccinated, albeit in weakened form. Second, protection provided by vaccination should be controlled in patients who have been vaccinated while receiving immunomodulatory or immunosuppressive treatment. In conclusion, there is evidence that systemic infections can worsen MS, thus vaccination will lower the risk of relapses by reducing the risk of infections. Therefore, vaccination should be in general recommended to MS patients.

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“…Another study by Broadley et al [22] claimed that no evidence was found to suggest that tonsillectomy affects the susceptibility to multiple sclerosis. The study by Eftekharian et al [23] had the closest results to ours-showing no significant association between appendectomy and tonsillectomy, and MS-and also suggested that if more people were included in the study groups, the results could potentially show greater significant differences.…”

Section: First-born Childmentioning

confidence: 48%

Risk Factors Associated with Multiple Sclerosis: A Case-Control Study in Damascus, Syria

Taan

¹

,

Ahmad

²

,

Ercksousi

³

et al. 2021

Multiple Sclerosis International

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Objectives. To assess the probable risk factors associated with Multiple sclerosis among Syrian patients in the city of Damascus. Method. In a case-control study conducted from May to September 2020, 140 MS patients and 140 healthy controls were selected from two main hospitals in Damascus. Data regarding risk factors associated with MS was collected via a structured questionnaire and complementary laboratory tests. The statistical analysis was carried out by the SPSS Statistical Software Version 26. Results. Factors such as smoking, family history of MS, migraine, and vitamin D deficiency were associated with a higher risk of developing MS: Smoking ( OR = 2.275 95% CI (1.348-3.841) P = 0.002 ). Family history of MS ( OR = 3.970 95% CI (1.807-8.719) P ≤ 0.001 ). Migraine ( OR = 3.011 95% CI (1.345-6.741) P = 0.005 ). Vitamin D deficiency ( OR = 4.778 95% CI (2.863-7.972) P ≤ 0.001 ). However, factors such as diabetes, hypertension, a surgical history of appendectomy, tonsillectomy, and being the first-born in a family were statistically irrelevant: Diabetes ( OR = 0.652 95% CI (0.226-1.882) P = 0.426 ). Hypertension ( OR = 1.445 95% CI (0.724-2.885) P = 0.295 ) Appendectomy ( OR = 1.269 95% CI (0.486-3.317) P = 0.626 ) Tonsillectomy ( OR = 1.280 95% CI (0.576-2.843) P = 0.544 ). First-born Child ( OR = 0.933 95% CI (0.558-1.562) P = 0.793 ). Conclusion. Our study suggests that smoking, vitamin D deficiency, family history of MS, and migraine are probable risk factors for multiple sclerosis. Therefore, engaging in outdoor activities and maintaining a healthy diet—for females in particular—is highly recommended.

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“…Although a small number of case–control studies have since reported an increase in risk of a first demyelinating event in the first few months following vaccination [ 58 – 60 ], the majority of case–control and observational studies have failed to demonstrate a significantly increased risk [ 60 – 69 ]. A French MS Society task force set up in 2017 eventually concluded that there was no evidence for an association [ 70 ] and recent meta-analyses have supported this position [ 71 ].…”

Section: Lessons Learnt From Historymentioning

confidence: 99%

Interpretation of vaccine associated neurological adverse events: a methodological and historical review

Cauchi

¹

,

Ball

²

,

Ben‐Shlomo

³

et al. 2021

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As a result of significant recent scientific investment, the range of vaccines available for COVID-19 prevention continues to expand and uptake is increasing globally. Although initial trial safety data have been generally reassuring, a number of adverse events, including vaccine induced thrombosis and thrombocytopenia (VITT), have come to light which have the potential to undermine the success of the vaccination program. However, it can be difficult to interpret available data and put these into context and to communicate this effectively. In this review, we discuss contemporary methodologies employed to investigate possible associations between vaccination and adverse neurological outcomes and why determining causality can be challenging. We demonstrate these issues by discussing relevant historical exemplars and explore the relevance for the current pandemic and vaccination program. We also discuss challenges in understanding and communicating such risks to clinicians and the general population within the context of the ‘infodemic’ facilitated by the Internet and other media.

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Multiple sclerosis and immunological-related risk factors: Results from a case-control study

Abstract: Considering previous global investigations on this topic with the result of our study, it seems more studies are needed to determine the definitive association between tonsillectomy, appendectomy and hepatitis B vaccination with multiple sclerosis.

Cited by 16 publications

References 55 publications

Vaccination in Multiple Sclerosis: Friend or Foe?

Vaccination in Multiple Sclerosis: Friend or Foe?

Risk Factors Associated with Multiple Sclerosis: A Case-Control Study in Damascus, Syria

Interpretation of vaccine associated neurological adverse events: a methodological and historical review

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