Examining the contributions of environmental quality to pediatric multiple sclerosis

for the U.S. Network of Pediatric MS Centers

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background Multiple sclerosis (MS) is a presumed autoimmune disease caused by genetic and environmental factors. It is hypothesized that environmental exposures (such as air and water quality) trigger the innate immune response thereby activating a pro-inflammatory cascade. Objective To examine potential environmental factors in pediatric MS using geographic information systems (GIS). Methods Pediatric MS cases and healthy controls were identified as part of an ongoing multicenter case-control study. Subjects’ geographic locations were mapped by county centroid to compare to an Environmental Quality Index (EQI). The EQI examines 5 individual environmental components (air, land, water, social, built factors). A composite EQI score and individual scores were compared between cases and controls, stratified by median proximity to enrollment centers (residence <20 or ≥20 miles from the recruiting center), using logistic regression. Results Of the 287 MS cases and 445 controls, 46% and 49% respectively live in areas where the total EQI is the highest (worst environmental quality). Total EQI was not significantly associated with the odds for MS (p = 0.90 < 20 miles from center; p = 0.43 ≥ 20 miles); however, worsening air quality significantly impacted the odds for MS in those living near a referral center (OR = 2.83; 95%CI 1.5, 5.4) and those who reside ≥ 20 miles from a referral center (OR = 1.61; 95%CI 1.2, 2.3). Conclusion Among environmental factors, air quality may contribute to the odds of developing MS in a pediatric population. Future studies will examine specific air constituents and other location-based air exposures and explore potential mechanisms for immune activation by these exposures.

Original languageEnglish (US)
Pages (from-to)164-169
Number of pages6
JournalMultiple Sclerosis and Related Disorders
Volume18
DOIs
StatePublished - Nov 1 2017

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Multiple Sclerosis
Pediatrics
Air
Referral and Consultation
Geographic Locations
Geographic Information Systems
Water Quality
Environmental Exposure
Innate Immunity
Autoimmune Diseases
Case-Control Studies
Logistic Models
Water
Population

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Examining the contributions of environmental quality to pediatric multiple sclerosis. / for the U.S. Network of Pediatric MS Centers.

In: Multiple Sclerosis and Related Disorders, Vol. 18, 01.11.2017, p. 164-169.

Research output: Contribution to journalArticle

for the U.S. Network of Pediatric MS Centers. / Examining the contributions of environmental quality to pediatric multiple sclerosis. In: Multiple Sclerosis and Related Disorders. 2017 ; Vol. 18. pp. 164-169.
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title = "Examining the contributions of environmental quality to pediatric multiple sclerosis",
abstract = "Background Multiple sclerosis (MS) is a presumed autoimmune disease caused by genetic and environmental factors. It is hypothesized that environmental exposures (such as air and water quality) trigger the innate immune response thereby activating a pro-inflammatory cascade. Objective To examine potential environmental factors in pediatric MS using geographic information systems (GIS). Methods Pediatric MS cases and healthy controls were identified as part of an ongoing multicenter case-control study. Subjects’ geographic locations were mapped by county centroid to compare to an Environmental Quality Index (EQI). The EQI examines 5 individual environmental components (air, land, water, social, built factors). A composite EQI score and individual scores were compared between cases and controls, stratified by median proximity to enrollment centers (residence <20 or ≥20 miles from the recruiting center), using logistic regression. Results Of the 287 MS cases and 445 controls, 46{\%} and 49{\%} respectively live in areas where the total EQI is the highest (worst environmental quality). Total EQI was not significantly associated with the odds for MS (p = 0.90 < 20 miles from center; p = 0.43 ≥ 20 miles); however, worsening air quality significantly impacted the odds for MS in those living near a referral center (OR = 2.83; 95{\%}CI 1.5, 5.4) and those who reside ≥ 20 miles from a referral center (OR = 1.61; 95{\%}CI 1.2, 2.3). Conclusion Among environmental factors, air quality may contribute to the odds of developing MS in a pediatric population. Future studies will examine specific air constituents and other location-based air exposures and explore potential mechanisms for immune activation by these exposures.",
author = "{for the U.S. Network of Pediatric MS Centers} and Lavery, {Amy M.} and Waldman, {Amy T.} and {Charles Casper}, T. and Shelly Roalstad and Meghan Candee and John Rose and Anita Belman and Bianca Weinstock-Guttman and Greg Aaen and Tillema, {Jan Mendelt} and Moses Rodriguez and Jayne Ness and Yolanda Harris and Jennifer Graves and Lauren Krupp and Leslie Benson and Mark Gorman and Manikum Moodley and Mary Rensel and Manu Goyal and Soe Mar and Tanuja Chitnis and Teri Schreiner and Tim Lotze and Benjamin Greenberg and Ilana Kahn and Jennifer Rubin and Emmanuelle Waubant",
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AU - Lavery, Amy M.

AU - Waldman, Amy T.

AU - Charles Casper, T.

AU - Roalstad, Shelly

AU - Candee, Meghan

AU - Rose, John

AU - Belman, Anita

AU - Weinstock-Guttman, Bianca

AU - Aaen, Greg

AU - Tillema, Jan Mendelt

AU - Rodriguez, Moses

AU - Ness, Jayne

AU - Harris, Yolanda

AU - Graves, Jennifer

AU - Krupp, Lauren

AU - Benson, Leslie

AU - Gorman, Mark

AU - Moodley, Manikum

AU - Rensel, Mary

AU - Goyal, Manu

AU - Mar, Soe

AU - Chitnis, Tanuja

AU - Schreiner, Teri

AU - Lotze, Tim

AU - Greenberg, Benjamin

AU - Kahn, Ilana

AU - Rubin, Jennifer

AU - Waubant, Emmanuelle

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N2 - Background Multiple sclerosis (MS) is a presumed autoimmune disease caused by genetic and environmental factors. It is hypothesized that environmental exposures (such as air and water quality) trigger the innate immune response thereby activating a pro-inflammatory cascade. Objective To examine potential environmental factors in pediatric MS using geographic information systems (GIS). Methods Pediatric MS cases and healthy controls were identified as part of an ongoing multicenter case-control study. Subjects’ geographic locations were mapped by county centroid to compare to an Environmental Quality Index (EQI). The EQI examines 5 individual environmental components (air, land, water, social, built factors). A composite EQI score and individual scores were compared between cases and controls, stratified by median proximity to enrollment centers (residence <20 or ≥20 miles from the recruiting center), using logistic regression. Results Of the 287 MS cases and 445 controls, 46% and 49% respectively live in areas where the total EQI is the highest (worst environmental quality). Total EQI was not significantly associated with the odds for MS (p = 0.90 < 20 miles from center; p = 0.43 ≥ 20 miles); however, worsening air quality significantly impacted the odds for MS in those living near a referral center (OR = 2.83; 95%CI 1.5, 5.4) and those who reside ≥ 20 miles from a referral center (OR = 1.61; 95%CI 1.2, 2.3). Conclusion Among environmental factors, air quality may contribute to the odds of developing MS in a pediatric population. Future studies will examine specific air constituents and other location-based air exposures and explore potential mechanisms for immune activation by these exposures.

AB - Background Multiple sclerosis (MS) is a presumed autoimmune disease caused by genetic and environmental factors. It is hypothesized that environmental exposures (such as air and water quality) trigger the innate immune response thereby activating a pro-inflammatory cascade. Objective To examine potential environmental factors in pediatric MS using geographic information systems (GIS). Methods Pediatric MS cases and healthy controls were identified as part of an ongoing multicenter case-control study. Subjects’ geographic locations were mapped by county centroid to compare to an Environmental Quality Index (EQI). The EQI examines 5 individual environmental components (air, land, water, social, built factors). A composite EQI score and individual scores were compared between cases and controls, stratified by median proximity to enrollment centers (residence <20 or ≥20 miles from the recruiting center), using logistic regression. Results Of the 287 MS cases and 445 controls, 46% and 49% respectively live in areas where the total EQI is the highest (worst environmental quality). Total EQI was not significantly associated with the odds for MS (p = 0.90 < 20 miles from center; p = 0.43 ≥ 20 miles); however, worsening air quality significantly impacted the odds for MS in those living near a referral center (OR = 2.83; 95%CI 1.5, 5.4) and those who reside ≥ 20 miles from a referral center (OR = 1.61; 95%CI 1.2, 2.3). Conclusion Among environmental factors, air quality may contribute to the odds of developing MS in a pediatric population. Future studies will examine specific air constituents and other location-based air exposures and explore potential mechanisms for immune activation by these exposures.

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