Multiple sclerosis (MS) is a disabling chronic disease with complex susceptibility factors, such as genetic factors and environmental exposures during early life. Although the disease predominantly affects adults, MS is now increasingly recognized in children. Our pilot data suggest that prior Epstein-Barr virus (EBV) infection, and carrying the HLA-DRB1*1501 allele increase susceptibility to MS in children. Intriguingly, the risk conferred by prior EBV infection may be much higher in HLA-DRB1*1501/1503 negative patients, suggesting a possible gene-environment interaction. The primary advantage of the proposed work is to identify risk factors and their respective contribution to developing MS, some of which are potentially modifiable. In addition, identifying interactions between risk factors in this very informative population will enhance our understanding of the molecular mechanisms that lead to developing the disease. Finally, confirming that risk factors are similar in both age groups will provide support for the extension of conventional management strategies from adults to children. The primary objective of this study is to determine if risk factors identified for adult MS such as HLA- DRB1*1501/1503, EBV, 25(OH) vitamin D3 insufficiency, and exposure to cigarette smoking are also risk factors for pediatric MS, and if there are interactions between them. This objective will be addressed in a prospective study of 640 early pediatric-onset MS cases and 1280 matched controls recruited through the Pediatric MS Network, and its Data Coordinating and Analysis Center.
The specific aims of this project are:
Aim I : To investigate whether genes known to increase MS susceptibility in adults also increase susceptibility in children.
Aim II : To investigate whether remote infections with EBV and other common viruses increase susceptibility to pediatric-onset MS.
Aim III : To investigate if vitamin D insufficiency increases the risk of developing pediatric-onset MS.
Aim I V: To determine if exposure to cigarette smoking increases the risk of developing pediatric-onset MS.
Aim V : To develop predictive models for susceptibility to pediatric-onset MS. Pediatric cases with early MS and matched controls will provide blood for genotyping, and viral and 25(OH) vitamin D3 status. In addition, comprehensive data will be gathered regarding environmental exposures in utero and during childhood. Studying the role of viruses and other environmental insults in the pediatric MS population provides a unique opportunity given the close temporal relationship between exposure and MS onset. In addition, we anticipate that subjects in whom the disease develops before adulthood are likely to have a higher load of risk factors, thus allowing for an easier detection of their effects and interactions.
Multiple sclerosis (MS), a disabling chronic disease, is thought to be caused by a combination of genetic and environmental risk factors. The purpose of this study is to investigate potentially important risk factors for MS in children.
|Graves, Jennifer S; Barcellos, Lisa F; Simpson, Steve et al. (2018) The multiple sclerosis risk allele within the AHI1 gene is associated with relapses in children and adults. Mult Scler Relat Disord 19:161-165|
|Aaen, Gregory; Waltz, Michael; Vargas, Wendy et al. (2018) Acquisition of Early Developmental Milestones and Need for Special Education Services in Pediatric Multiple Sclerosis. J Child Neurol :883073818815041|
|Nourbakhsh, Bardia; Rutatangwa, Alice; Waltz, Michael et al. (2018) Heterogeneity in association of remote herpesvirus infections and pediatric MS. Ann Clin Transl Neurol 5:1222-1228|
|Azary, Saeedeh; Schreiner, Teri; Graves, Jennifer et al. (2018) Contribution of dietary intake to relapse rate in early paediatric multiple sclerosis. J Neurol Neurosurg Psychiatry 89:28-33|
|Suleiman, Leena; Waubant, Emmanuelle; Aaen, Gregory et al. (2018) Early infectious exposures are not associated with increased risk of pediatric-onset multiple sclerosis. Mult Scler Relat Disord 22:103-107|
|Nourbakhsh, Bardia; Bhargava, Pavan; Tremlett, Helen et al. (2018) Altered tryptophan metabolism is associated with pediatric multiple sclerosis risk and course. Ann Clin Transl Neurol 5:1211-1221|
|Lavery, Amy M; Waubant, Emmanuelle; Casper, T Charles et al. (2018) Urban air quality and associations with pediatric multiple sclerosis. Ann Clin Transl Neurol 5:1146-1153|
|Pakpoor, Julia; Seminatore, Brandon; Graves, Jennifer S et al. (2018) Dietary factors and pediatric multiple sclerosis: A case-control study. Mult Scler 24:1067-1076|
|Gianfrancesco, Milena A; Stridh, Pernilla; Shao, Xiaorong et al. (2017) Genetic risk factors for pediatric-onset multiple sclerosis. Mult Scler :1352458517733551|
|Graves, Jennifer S; Chitnis, Tanuja; Weinstock-Guttman, Bianca et al. (2017) Maternal and Perinatal Exposures Are Associated With Risk for Pediatric-Onset Multiple Sclerosis. Pediatrics 139:|
Showing the most recent 10 out of 34 publications