title: The Multiple Sclerosis Severity Score: associations with MC1R single nucleotide polymorphisms and host response to ultraviolet radiation.
abstract: BACKGROUND
  Multiple sclerosis outcome may be influenced by ultraviolet radiation and vitamin D synthesis, suggesting skin type and genes determining this phenotype are candidates for disability. However, though associations between melanocortin 1 receptor (MC1R) single nucleotide polymorphisms and disability are reported, some data are incompatible with their expected influence on skin type.
  
  
  OBJECTIVE
  Determine which MC1R single nucleotide polymorphisms affect disability and establish if ultraviolet radiation modifies such associations.
  
  
  METHODS
  We studied using linear regression in 525 cases, associations of the Multiple Sclerosis Severity Score (MSSS) with skin type, gender, ultraviolet radiation exposure and six MC1R single nucleotide polymorphisms (rs1805005, rs1805006, rs2228479, rs1805007, rs1805008, rs1805009).
  
  
  RESULTS
  CG(294) with GG(294) genotypes (rs1805009) (coefficient = -1.44, 95% CI -2.30, -0.59, mean MSSS +/- SD = 4.33 +/- 2.87) and AC(84) (rs1805006) (coefficient = 1.62, 95% CI 0.17, 3.06, mean MSSS = 7.62 +/- 2.43) were associated with MSSS. Associations with Asp294His were found in those with skin types 1/2 and 3/4, and cases stratified by ultraviolet radiation exposure. However, they were seen only in cases with a history of childhood sunburn and not in those without sunburn. We found no significant associations between exposure parameters and MSSS.
  
  
  CONCLUSIONS
  Multiple sclerosis outcome is influenced by interactions between host response to ultraviolet radiation and MC1R single nucleotide polymorphisms. The influence of the single nucleotide polymorphisms appears distinct from their association with skin type.
authors.affiliation: Keele Multiple Sclerosis Research Group, Department of Neurology, University Hospital of North Staffordshire, Stoke-on-Trent, UK.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Strange
authors.forename: Sudarshan
authors.initials: S
authors.lastname: Ramachandran
authors.forename: Maurice P
authors.initials: MP
authors.lastname: Zeegers
authors.forename: Richard D
authors.initials: RD
authors.lastname: Emes
authors.forename: Roby
authors.initials: R
authors.lastname: Abraham
authors.forename: Vythilingam
authors.initials: V
authors.lastname: Raveendran
authors.forename: Mike
authors.initials: M
authors.lastname: Boggild
authors.forename: Janice
authors.initials: J
authors.lastname: Gilford
authors.forename: Clive P
authors.initials: CP
authors.lastname: Hawkins
mesh_terms: D004185:Disability Evaluation; D004739:England; D005260:Female; D005787:Gene Frequency; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D016014:Linear Models; D008297:Male; D008958:Models, Molecular; D020528:Multiple Sclerosis, Chronic Progressive / Q000175:diagnosis* / Q000235:genetics; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis* / Q000235:genetics; D010641:Phenotype; D020641:Polymorphism, Single Nucleotide; D011487:Protein Conformation; D044102:Receptor, Melanocortin, Type 1 / Q000737:chemistry / Q000235:genetics*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012867:Skin / Q000528:radiation effects*; D013472:Sunlight; D011795:Surveys and Questionnaires; D013997:Time Factors; D014466:Ultraviolet Rays
chemical_list: D044102:Receptor, Melanocortin, Type 1