Search

Background and purpose Our objective was to study the association between serum levels of anti Epstein-Barr virus nuclear antigen 1 ( EBNA-1) antibody and 25-hydroxyvitamin D (25( OH)D) in a prospective cohort of patients with relapsing−remitting multiple sclerosis. Method The study comprised 90 patients with relapsing−remitting multiple sclerosis, all participants in a randomized clinical trial of ω-3 fatty acids (the OFAMS study). Repeated, paired measurements of serum 25( OH)D and serum EBNA-1 immunoglobulin G (IgG) levels were obtained at baseline and every 6 months for 24 months. The association between serum EBNA-1 IgG and serum 25( OH)D levels was analysed using generalized linear models for hierarchical data. Results There was a significant variation in EBNA-1 IgG antibody level between sampling months ( Fdf 11 = 1.8, P = 0.043, one-way anova). There was a negative association between EBNA-1 IgG and 25( OH)D [ B = −0.230, 95% confidence interval ( CI) (−0.440, −0.023), P = 0.030] and a positive association between EBNA-1 IgG and HLA- DRB1*15 positive status [ B = 94.7, 95% CI (2.423, 186.9), P = 0.044]. The association between 25( OH)D and EBNA-1 IgG remained significant after adjusting for the patient's age, gender, HLA- DRB1*15, retinol levels and interferon β-1a treatment. Conclusion Our study demonstrates monthly differences in EBNA-1 IgG levels and an association between EBNA-1 IgG, 25( OH)D levels and HLA- DRB1*15. These results indicate that EBNA-1 IgG serum levels are affected by genetic and environmental factors that also modulate multiple sclerosis risk. [ABSTRACT FROM AUTHOR]

Background It has been suggested that polymorphisms in the WT1 gene modulate the effect of IFN- β treatment in multiple sclerosis ( MS) through regulation of the relationship between IFN- β and vitamin D. Objective To examine whether WT1 modulates the relationship between IFN- β and vitamin D in a longitudinal study with repeated assessment of vitamin D before and after initiation of IFN- β. Methods In a prospective study of 85 patients with relapsing remitting MS, 25-hydroxyvitamin D was measured at month 0, 1, 3, 6, 7, 9, 12, 18 and 24. None of the patients used any immunomodulatory treatment at inclusion, and all started IFN- β treatment at month 6. Results The mean concentrations of seasonally adjusted 25-hydroxyvitamin increased slightly (3.1 ± 1.2 nmol/l, P = 0.008) after initiation of IFN- β. The association between IFN- β treatment and 25-hydroxyvitamin D was similar in patients carrying any of the two alleles in the WT1 SNPs (rs10767935 and rs5030244) recently reported to modulate this relationship. Conclusions In this prospective study with repeated measurements of 25-hydroxyvitamin D before and during treatment with IFN- β, we did not find that genetic variation in WT1 plays any role in regulating the relationship between IFN- β and serum 25-hydroxyvitamin D. [ABSTRACT FROM AUTHOR]

Background/Aim: 25-Hydroxyvitamin D (25(OH)D) levels are suggested to influence the susceptibility and risk of disease progression in multiple sclerosis (MS). Seasonal fluctuation of 2S(OH)D levels may differ in magnitude between individuals. The purpose of this paper was to model the seasonal fluctuation of vitamin D in Norwegian MS patients and to examine to which extent one single 25(OH)D measurement predicts the level at other time points throughout the year. Methods: During December 2004 and July 2008, 762 serum samples were collected from 92 Norwegian relapsing-remitting MS patients. Time series analysis and multi-variate modelling techniques were used to model seasonal fluctuations and intra- and inter-individual variations in 25(OH)D values. Results: Most patients reached their lowest 25(OH)D level in March/April and the highest in July/August. There were substantial intra-individual variations in the ex tent of seasonal fluctuation, with 36.6% of explainable variation in seasonally adjusted 2S(OH)D levels (on a logarithmic scale) attributable to the patient level. The remaining 63.4% could be accounted for by sources of inter-individual variation. Both the total and inter-individual variabilities were lowest in February, and the prediction interval in this month was up to 26% narrower compared to other months. The prediction intervals would be at least 21% wider with only one observation available per patient. Conclusions: The seasonal fluctuations of 25(OH)D levels in Norwegian relapsing-remitting MS patients are subject to pronounced intra- and inter-individual variation. The most representative measurements of 25(OH)D levels are taken in February. [ABSTRACT FROM AUTHOR]

Shirzadi M, Alvestad S, Hovdal H, Espeset K, Lydersen S, Brodtkorb E. Comparison of carbamazepine rash in multiple sclerosis and epilepsy. Acta Neurol Scand: 2012: 125: 60-63. © 2011 John Wiley & Sons A/S. Objectives - Studies on the comorbidity of multiple sclerosis (MS) and allergic disorders have shown conflicting results. Carbamazepine (CBZ) is widely used in MS to control pain. We have compared the incidence of rash from CBZ use in MS and epilepsy. Materials and Methods - Consecutive adult patients with MS and epilepsy were studied retrospectively. A detailed survey of medical records concerning CBZ treatment was performed. Results - A total of 495 patients with epilepsy and 442 patients with MS were included. Sixty-five per cent of patients with epilepsy and 20% of patients with MS had used CBZ. In CBZ-exposed patients, rash occurred in 15/89 (17%) in MS and in 43/323 (13%) in epilepsy, a difference which was not significant. Women below 50 years experienced more skin reactions than older women and men. The unadjusted odds ratio (OR) for rash in the MS vs epilepsy group was 1.32 (CI 0.70-2.51, P = 0.40). Adjusting groups for gender and age reduced the OR to 1.11 (CI 0.56-2.19, P = 0.76). Conclusion - Compared with epilepsy, which is only rarely caused by immunological mechanisms, the autoimmune disorder MS was not associated with a different occurrence of CBZ skin reactions. The trend towards an increased occurrence of rashes in MS can partly be explained by a higher predisposition to CBZ rash in women of fertile age. [ABSTRACT FROM AUTHOR]

The level of interleukin-10 (IL-10) expression is related to polymorphisms -1082 (G/A), -819 (T/C) and -592 (A/C) in the promoter region of the IL-10 gene, which constitute three haplotypes, GCC, ATA, and ACC. The ATA (a non-GCC) haplotype, which is associated with low IL-10 expression, has been shown to improve interferon (IFN) treatment response in hepatitis C. We analysed the distribution of IL-10 promoter haplotype combinations to determine whether they could influence initial IFN treatment response in 63 patients with relapsing-remitting multiple sclerosis (MS). The patients were grouped into non-GCC or GCC haplotypes, and the clinical and magnetic resonance imaging (MRI) disease activity was compared in the two groups. During the first 6 months of treatment, MS patients with non-GCC haplotypes experienced fewer new MRI T1-contrast enhancing lesions [0.77 ± 0.36 (SEM)] than patients with the GCC haplotype (2.45 ± 0.57) (P = 0.05, Mann-WhitneyUtest). No differences were detected on clinical disease activity. The results suggest an influence of IL-10 promoter polymorphisms on IFN treatment response in MS. [ABSTRACT FROM AUTHOR]