Multiple sclerosis epidemiological trends in Italy highlight the environmental risk factors

Puthenparampil, Marco; Perini, Paola; Bergamaschi, Roberto; Capobianco, Marco; Filippi, Massimo; Gallo, Paolo

doi:10.1007/s00415-021-10782-5

Cited by 14 publications

(10 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The authors suggested that this might be due to lower vitamin D levels in mountain dwellers caused by limited access to sunlight in mountain environments, exposure to magnetic fields and other factors related to the highaltitude environment, as well as a higher incidence of infections that may play a role in the development of MS (23, 24). However, in a study conducted in Italy by Puthenparampil et al (25), no such connection was found. According to the authors, genetic or other environmental factors in the Italian highlands do not have the same impact on the incidence of MS as in Switzerland (25).…”

Section: Negative Impact Of Mountainous Terrain On Ms Patientsmentioning

confidence: 88%

Influence of mountain climate on multiple sclerosis

Kadyrova,

Jusupova,

Dzhaparalieva

et al. 2023

HVT

View full text Add to dashboard Cite

Objective: Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system. Although the exact cause of multiple sclerosis is unknown, it is believed to be a combination of genetic and environmental factors. One of the environmental factors is climate, including the influence of the mountain climate on this disease. We aimed to analyze current evidence on influence of mountain climate on multiple sclerosis. Methods: We followed the guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Reviewers systematically searched Scopus, PubMed and EMBASE for peer-reviewed publications in English from January 1994 to December 2022 reporting MS and influence of mountain climate. The outcome was change in MS incidence rate according to geographical region. Results: The mountainous climate is characterized by high-altitude, low humidity and extreme temperatures, which can have both positive and negative effects on multiple sclerosis. On the one hand, a cold and dry mountain climate can be beneficial for people with multiple sclerosis, as it can reduce inflammation and improve symptoms such as fatigue, cognitive impairment, and spasticity. In addition, high altitude may have a protective effect on multiple sclerosis, as it is associated with a lower incidence rate. On the other hand, mountain climates can also have a negative impact on multiple sclerosis, especially in terms of vitamin D deficiency. Sun exposure is the main source of vitamin D, and people living at higher altitudes get less sunlight due to the thinner atmosphere, resulting in the body producing less vitamin D. Conclusion: Thus, the influence of mountain climate on multiple sclerosis is complex and depends on many factors. Further research is needed to better understand the relationship between altitude and MS risk.

show abstract

Section: Negative Impact Of Mountainous Terrain On Ms Patientsmentioning

confidence: 88%

Influence of mountain climate on multiple sclerosis

Kadyrova,

Jusupova,

Dzhaparalieva

et al. 2023

HVT

View full text Add to dashboard Cite

show abstract

“…A latitudinal prevalence gradient also exists in Latin America between Panama and Argentina [ 6 ]. However, the latitude gradient did not fit an Italian map for MS, especially in the islands of Sardinia and Sicily [ 7 ]. Living in a high UV-B environment with summer exposure during childhood in the years leading up to MS onset was associated with a lower MS risk [ 8 ].…”

Section: Background and Introductionmentioning

confidence: 99%

Triggering multiple sclerosis at conception and early gestation: The variation in ultraviolet radiation is as important as its intensity

Davis

Lowell

2023

Heliyon

View full text Add to dashboard Cite

“…MS is characterized by five major phenotypes, namely the clinically isolated syndrome (CIS), relapsing-remitting (RR), primary progressive (PP), progressive-relapsing (PR), and secondary progressive MS (SP) [4,5]. The same risk factors, i.e., genetic patterns, tobacco smoking, exposure to air pollutants, viral infections, low vitamin D levels, and juvenile obesity [6,7], also affect the type and severity of the disease. Other factors unrelated to demographic and clinical features, like the variability of contacts, diagnostic paths, and therapeutic capabilities, may also influence the MS phenotypes.…”

Section: Introductionmentioning

confidence: 99%

Do patients’ and referral centers’ characteristics influence multiple sclerosis phenotypes? Results from the Italian multiple sclerosis and related disorders register

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background Multiple sclerosis (MS) is characterized by phenotypical heterogeneity, partly resulting from demographic and environmental risk factors. Socio-economic factors and the characteristics of local MS facilities might also play a part. Methods This study included patients with a confirmed MS diagnosis enrolled in the Italian MS and Related Disorders Register in 2000–2021. Patients at first visit were classified as having a clinically isolated syndrome (CIS), relapsing–remitting (RR), primary progressive (PP), progressive-relapsing (PR), or secondary progressive MS (SP). Demographic and clinical characteristics were analyzed, with centers’ characteristics, geographic macro-areas, and Deprivation Index. We computed the odds ratios (OR) for CIS, PP/PR, and SP phenotypes, compared to the RR, using multivariate, multinomial, mixed effects logistic regression models. Results In all 35,243 patients from 106 centers were included. The OR of presenting more advanced MS phenotypes than the RR phenotype at first visit significantly diminished in relation to calendar period. Females were at a significantly lower risk of a PP/PR or SP phenotype. Older age was associated with CIS, PP/PR, and SP. The risk of a longer interval between disease onset and first visit was lower for the CIS phenotype, but higher for PP/PR and SP. The probability of SP at first visit was greater in the South of Italy. Discussion Differences in the phenotype of MS patients first seen in Italian centers can be only partly explained by differences in the centers’ characteristics. The demographic and socio-economic characteristics of MS patients seem to be the main determinants of the phenotypes at first referral.

show abstract

Multiple sclerosis epidemiological trends in Italy highlight the environmental risk factors

Cited by 14 publications

References 60 publications

Influence of mountain climate on multiple sclerosis

Influence of mountain climate on multiple sclerosis

Triggering multiple sclerosis at conception and early gestation: The variation in ultraviolet radiation is as important as its intensity

Do patients’ and referral centers’ characteristics influence multiple sclerosis phenotypes? Results from the Italian multiple sclerosis and related disorders register

Contact Info

Product

Resources

About