title: Apolipoprotein E polymorphism interacts with cigarette smoking in progression of multiple sclerosis.
abstract: OBJECTIVE
  The influence of apolipoprotein E (ApoE) polymorphism on clinical severity of multiple sclerosis (MS) is still controversial. Cigarette smoking has been suggested to influence the progression of disability in these patients. In this study, we aimed to investigate whether an interaction of smoking with the ApoE polymorphism influences the progression of disability in MS patients.
  
  
  METHODS
  Smoking history from 205 female patients with MS was obtained. Clinical data collected include age at onset, disease duration, annual relapse rate, the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Severity Score (MSSS). ApoE polymorphism was examined in all patients and stratified according to smoking status and associations with the clinical data investigated.
  
  
  RESULTS
  There were no significant associations between cigarette smoking and any of the clinical characteristics in the whole group of patients. In women carrying the ApoE E4 isoform, smokers had a lower EDSS (P = 0.033) and MSSS (P = 0.023) in comparison with non-smokers.
  
  
  CONCLUSIONS
  Our data suggest that in women with MS carrying the ApoE E4 isoform, cigarette smoking may have a protective influence on disease progression and accumulation of disability. These findings need to be confirmed by future large longitudinal studies.
authors.affiliation: Department of Biochemistry, Faculty of Medical Sciences, UNL, Lisbon, Portugal. arsena@fcm.unl.pt
authors.forename: A
authors.initials: A
authors.lastname: Sena
authors.forename: R
authors.initials: R
authors.lastname: Couderc
authors.forename: V
authors.initials: V
authors.lastname: Ferret-Sena
authors.forename: R
authors.initials: R
authors.lastname: Pedrosa
authors.forename: M L
authors.initials: ML
authors.lastname: Andrade
authors.forename: C
authors.initials: C
authors.lastname: Araujo
authors.forename: R
authors.initials: R
authors.lastname: Roque
authors.forename: M J
authors.initials: MJ
authors.lastname: Cascais
authors.forename: M G
authors.initials: MG
authors.lastname: Morais
mesh_terms: D000328:Adult; D001057:Apolipoproteins E / Q000235:genetics; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000235:genetics* / Q000503:physiopathology*; D011110:Polymorphism, Genetic / Q000235:genetics*; D012720:Severity of Illness Index; D012907:Smoking / Q000235:genetics*
chemical_list: D001057:Apolipoproteins E