MS is on the increase. It is showing an Environmental Issue.

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Walton C, King R, Rechtman L, Kaye W, Leray E, Marrie RA, Robertson N, La Rocca N, Uitdehaag B, van der Mei I, Wallin M, Helme A, Angood Napier C, Rijke N, Baneke P. Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Mult Scler. 2020 Nov 11:1352458520970841. doi: 10.1177/1352458520970841. Epub ahead of print. PMID: 33174475.

What is the cause of MS. Genetics? But this study shows that environmental influences are equally if not more important. It says disease is modifyable if we change the environmental triggers, but at the moment we are clearly doing the opposite. MS is on the increase in all parts of the globe….Have our genes changed that much is the past few decades.

Background: High-quality epidemiologic data worldwide are needed to improve our understanding of disease risk, support health policy to meet the diverse needs of people with multiple sclerosis (MS) and support advocacy efforts.

Objectives: The Atlas of MS is an open-source global compendium of data regarding the epidemiology of MS and the availability of resources for people with MS reported at country, regional and global levels.

Methods: Country representatives reported epidemiologic data and their sources via survey between September 2019 and March 2020, covering prevalence and incidence in males, females and children, and age and MS type at diagnosis. Regional analyses and comparisons with 2013 data were conducted.

Results: A total of 2.8 million people are estimated to live with MS worldwide (35.9 per 100,000 population). MS prevalence has increased in every world region since 2013 but gaps in prevalence estimates persist. The pooled incidence rate across 75 reporting countries is 2.1 per 100,000 persons/year, and the mean age of diagnosis is 32 years. Females are twice as likely to live with MS as males.

Conclusions: The global prevalence of MS has risen since 2013, but good surveillance data is not universal. Action is needed by multiple stakeholders to close knowledge gaps.

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MouseDoctor

14 comments

  • Epigenetic? Genes loading the gun and environment pulling the trigger? And environment being any number of external forces – EBV, Head injury, stress/trauma. Fascinating!

  • I wonder why it is on the increase? Smoking rates are going down in the developed world. Is it increasing vitamin d deficiency rates? Epstein Barr virus is just really common anyway. I would love to get to the bottom of this mystery to prevent this affliction on other people!

  • How much of the ‘higher prevalence’, if any, could be attributed to greater awareness and diagnosis? MS surely have existed before it had a name? Maybe possible that way back people who had MS were ‘diagnosed’ with something else? Or is that completely crazy?

    • Not crazy….but historically we would die earlier and young men would be out fighting and historically we may have got EBV in childhood and our immune response would be shaped differently…but the truth is I don’t know.

  • We need antiretroviral trials that target EBV both in central nervous system and in the blood stream to see the day of light in multiple sclerosis. Also hopefully after this coronavirus pandemic I hope vaccine development will be faster for an EBV vaccine.

  • I use a builder of Iranian origin. A heavy smoker and sure is indulging in multiple partners behind his wife’s back. He started to tell me he couldn’t see from his left and the same side was numb. My First thought was covid attacking his nerve. Then 2nd thought MS. His had multiple MRI and he confirmed that he had MS. I wanted to share with my MS Journey but thought he might blame me for catching MS. Given none knows for definite what causes ms thought instay stem.

  • Is incidence increasing with change of dietary habits? I remember I looked at the increase in MS cases in Japan and meat consumption. There are generic reports talking about westernization of lifestyle. I remember also that age of puberty is decreasing in developing country with improved and increased protein intake so this could add to increase the build up of the environmental factor.

    I did this search while looking for something that is highly expressed in the brain, that can come from dietary habits and that could trigger immunity. So I thought that Neu5Gc that is immunogenic, found in animal meat (increased consumption) and can replace neu5ac in brain glycoproteins could have some role. It is not possible to find a person that is completely Neu5Gc free as it is unlikely that someone from birth to death never eat this sugar. If the mother eats meat Neu5Gc it will pass to the baby via breastfeeding. So going vegan won’t solve the point as once you had it it stays where it is. Going vegan should be done for generations before seeing any effect.

    And another point that I thought had some additional connection with this is that monkeys (callytrix) that lack the same gene human lacks (CMAH) can develop MS like disease after viral infection. That gene turns neu5ac into neu5gc. Other monkeys that have a functioning copy of the gene do not develop the disease… or maybe they are resistant to the virus?

    Of course this is not sufficient to explain because other factors need to play a role otherwise everyone would get MS, so EBV, immune response out of control and probably something else maybe genetic.

    And finally correlation does not mean causality… but maybe it could be something interesting to be studied.

  • ” all parts of the globe”

    What about the “farther away from the equator the more risk you sustain for develop ms” hyphotesis?

    Does still holds?

  • Is there anywhere where the rate is dropping? As the saying goes, on average I am comfortable with my head in the freezer and my feet in the oven. Where the extremes occur is more important.

  • So what happens as you cross the Straights of Gibraltar? It goes from 100-200 per 100,000 to 0-25 per 100,000. I notice that living at the equator helps.

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