Evaluating the association of allergies with multiple sclerosis susceptibility risk and disease activity in a pediatric population.
BACKGROUND
Multiple sclerosis (MS) and allergies are both considered to be related to imbalanced Th1 and Th2 immune responses. Previous studies evaluating the relationship between MS and allergies provide conflicting results.


OBJECTIVE
To assess allergies and asthma as risk factors for MS and as predictors of MS relapses in a pediatric cohort.


METHODS
The environment and genetic risk factors for pediatric MS study is a national case-control project with 16 participating US sites. An environmental questionnaire is used that includes history of allergies in the first five years of life. Case-control data are entered in the pediatric MS Network database and cases at 12 of the 16 sites enter relapse data prospectively. Annualized relapse rate was calculated for patients with follow-up and adjusted for age at disease onset, gender, race, ethnicity, and use of disease-modifying therapy (DMT).


RESULTS
We included 271 cases (mean age at disease onset of 15.7years and 62% female) and 418 controls. Relapse data were available for 193 cases. There was no difference in prevalence of allergies or asthma between cases and controls. Patients with food allergies had fewer relapses compared to patients without food allergies (0.14 vs 0.48, p=0.01).


CONCLUSIONS
While allergies and asthma are not associated with pediatric MS, cases with food allergies have fewer relapses compared to those without food allergies.
State University of New York, Neurology, United States. Electronic address: theresaneiderer@gmail.com.
Theresa
T
Bourne
University of Utah, Pediatrics, United States.
Michael
M
Waltz
University of Utah, Pediatrics, United States.
T C
TC
Casper
State University of New York, Neurology, United States.
K
K
Kavak
Loma Linda University, Neurology, United States.
G
G
Aaen
SUNY Stony Brook, Neurology, United States.
A
A
Belman
Massachusetts General Hospital, Partners Pediatric Multiple Sclerosis Center, United States.
L
L
Benson
University of Utah, Pediatrics, United States.
M
M
Candee
Brigham and Women's Hospital, Neurology, United States.
T
T
Chitnis
Multiple Sclerosis Center, University of California, San Francisco, CA, United States.
J
J
Graves
University of Texas Southwestern, Neurology, United States.
B
B
Greenberg
Massachusetts General Hospital, Partners Pediatric Multiple Sclerosis Center, United States.
M
M
Gorman
University of Alabama at Birmingham, Pediatrics, United States.
Y
Y
Harris
SUNY Stony Brook, Neurology, United States.
L
L
Krupp
Texas Children's Hospital, Child Neurology, United States.
T
T
Lotze
Washington University St. Louis, Neurology, United States.
S
S
Mar
University of Alabama at Birmingham, Pediatrics, United States.
J
J
Ness
University of Utah, Pediatrics, United States.
C
C
Olsen
University of Utah, Pediatrics, United States.
S
S
Roalstad
Mayo Clinic, Neurology, United States.
M
M
Rodriguez
University of Utah, Neurology, United States.
J
J
Rose
Ann & Robert Lurie Children's Hospital of Chicago, Neurology, United States.
J
J
Rubin
University of Colorado School of Medicine, Neurology, United States.
T
T
Schreiner
Mayo Clinic, Neurology, United States.
J M
JM
Tillema
Children's National Medical Center, Washington, United States.
I
I
Kahn
Children's Hospital of Philadelphia, Neurology, United States.
A
A
Waldman
University of California Berkeley, United States.
L
L
Barcellos
Multiple Sclerosis Center, University of California, San Francisco, CA, United States.
E
E
Waubant
State University of New York, Neurology, United States.
B
B
Weinstock-Guttman
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology; D016022:Case-Control Studies; D015331:Cohort Studies; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology*; D008297:Male; D009103:Multiple Sclerosis / Q000453:epidemiology*; D012307:Risk Factors
Allergies; Multiple sclerosis; Pediatric