title: Environmental risk factors for multiple sclerosis: a review with a focus on molecular mechanisms.
abstract: Multiple sclerosis (MS) is a chronic disabling disease of the central nervous system commonly affecting young adults. Pathologically, there are patches of inflammation (plaques) with demyelination of axons and oligodendrocyte loss. There is a global latitude gradient in MS prevalence, and incidence of MS is increasing (particularly in females). These changes suggest a major role for environmental factors in causation of disease. We have reviewed the evidence and potential mechanisms of action for three exposures: vitamin D, Epstein Barr virus and cigarette smoking. Recent advances supporting gene-environment interactions are reviewed. Further research is needed to establish mechanisms of causality in humans and to explore preventative strategies.
authors.affiliation: School of Medicine, Griffith University, Gold Coast, Queensland 4222, Australia.
authors.forename: Cullen
authors.initials: C
authors.lastname: O'Gorman
authors.affiliation: National Centre for Epidemiology and Population Health, the Australian National University, Canberra, Australian Capital Territory 0200, Australia.
authors.forename: Robyn
authors.identifier: 0000-0003-2736-3541
authors.initials: R
authors.lastname: Lucas
authors.affiliation: Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania 7000, Australia.
authors.forename: Bruce
authors.initials: B
authors.lastname: Taylor
mesh_terms: D000328:Adult; D000818:Animals; D004781:Environmental Exposure / Q000009:adverse effects*; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000378:metabolism; D006801:Humans; D007249:Inflammation; D008297:Male; D009103:Multiple Sclerosis / Q000209:etiology / Q000235:genetics / Q000378:metabolism; D009836:Oligodendroglia / Q000378:metabolism / Q000473:pathology; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D014807:Vitamin D / Q000378:metabolism
chemical_list: D014807:Vitamin D
keywords: Epstein-Barr virus; demyelination; epidemiology; gene-environment interaction; latitude; multiple sclerosis; smoking; vitamin D