Multiple sclerosis epidemiology

Wingerchuk DM, Weinshenker BG (2000) Multiple sclerosis Epidemiology, genetics, classification, natural history, and clinical outcome measures. Neuroimaging Clin N Am 10 611-624. 

Ascherio A Munch M (2000) Epstein-Barr virus and multiple sclerosis. Epidemiology, 11 220-224. 

McMichael A Hall AJ (1997) Ultaviolet radiation explaining the latitude effect in multiple sclerosis Epidemiology, 8 642-645. 

Riise T, Moen BE, Kyvik KR (2002) Organic solvents and the risk of multiple sclerosis. Epidemiology, 13 718-720. 

For some autoimmune diseases, little is known about environmental factors involved in the initiation or progression of the disease. For other diseases, however, considerable research has been conducted on one or more types of exposures. Most epidemiologic studies of environmental influences have focused on multiple sclerosis, rheumatoid arthritis, scleroderma, systemic lupus erythematosus, and small vessel vasculitis, but experimental studies using murine models of these diseases is limited (Table 25.1). 

Strong mechanistic evidence from rodent models of autoimmune disease of viral or other infectious agents affecting autoimmunity or progression to overt disease, but harder to demonstrate in humans. Enterovirus (Coxsackie virus) focus of epidemiologic studies in type 1 diabetes, Epstein-Barr virus focus of epidemiologic studies in multiple sclerosis and systemic lupus erythematosus. 

Several epidemiologic studies of scleroderma, undifferentiated connective tissue disease, and multiple sclerosis suggest modest associations with any solvents or with organic or chlorinated solvents Trichloroethylene, paint removers, and mineral spirits are some of the specific solvents implicated in these studies. Mechanistic research in MRL +/+ lupus mice. 

Mortensen, J.T., Bronnum-Hansen, H., and Rasmussen, K. Multiple sclerosis and organic solvents, Epidemiology, 9, 168, 1998. 

Slow viruses are becoming increasingly suspect in the instances of much more common diseases, particularly the autoimmune diseases. An autoimmune disease may be defined as a disease wheiein the immune system of the body does not direct its attack on an invading foreign substance, but instead at the body s own tissue. Many authorities consider rheumatoid arthritis and multiple sclerosis as autoimmune diseases. The precise causes of these diseases have remained obscure. Multiple sclerosis is a demyelinating disease and has variously been described as an autoimmune disease, a viral disease, or an autoimmune disease provoked by a virus. Epidemiological studies indicate that from 3 to 23 years may elapse between the time of exposure to the virus and the onset of symptoms. Further evidence points to involvement of a myxovirus. Measles virus is of this kind. 

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Bobowick AR, Kurtzke JF, Brody JA, Hrubec Z, Gillespie M (1978) Twin study of multiple sclerosis An epidemiologic inquiry. Neurology 28 978-987. 

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McLeod JG, Hammond SR, Hallpike JE (1994) Epidemiology of multiple sclerosis in Australia. With NSW and SA survey results. Med JAust 160 117-122. 

Weinshenker BG (1996) Epidemiology of multiple sclerosis. Neurol Clin 14 291-308. 

Midgard R, Riise T, Nyland H (1991) Epidemiologic trends in multiple sclerosis in More and Romsdal, Norway a prevalence/inci-dence study in a stable population. Neurology 41 887-92. 

Amaducci L, Arfioli C, Inzitari D, Mrachi M. Multiple sclerosis among shoe and leather workers An epidemiological survey in Florence. Acta Neurol Scand 1982, 65(2) 94 103. 

Landtblom AM, Flodin U, Soderfeldt B, et al. Organic solvents and multiple sclerosis A synthesis of the current evidence. Epidemiology 1996 7(4) 429-33. 

Wynn DR, Rodriguez M, O Fallon WM, et al. Update on the epidemiology of multiple sclerosis. Mayo Clin Proc 1989 64 808-817. 

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