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Role of environmental factors in multiple sclerosis

journal contribution
posted on 2023-05-21, 03:05 authored by Amin ZarghamiAmin Zarghami, Li, Y, Susan ClaflinSusan Claflin, Ingrid van der MeiIngrid van der Mei, Bruce TaylorBruce Taylor

Introduction: Environmental factors play a significant role in the pathogenesis and progression of multiple sclerosis (MS), either acting alone or by interacting with other environmental or genetic factors. This cumulative exposure to external risk factors is highly complex and highly variable between individuals.

Areas covered: We narratively review the current evidence on the role of environment-specific risk factors in MS onset and progression, as well as the effect of gene-environment interactions and the timing of exposure We have reviewed the latest literature, by Ovid Medline, retrieving the most recently published systematic reviews and/or meta-analyses and more recent studies not previously included in meta-analyses or systematic reviews.

Expert opinion: There is some good evidence supporting the impact of some environmental risk factors in increasing the risk of developing MS. Tobacco smoking, low vitamin D levels and/or low sun exposure, Epstein Barr Virus (EBV) seropositivity and a history of infectious mononucleosis may increase the risk of developing MS. Additionally, there is some evidence that gene-smoking, gene-EBV, and smoking-EBV interactions additively affect the risk of MS onset. However, the evidence for a role of other environmental factors in MS progression is limited. Finally, there is some evidence that tobacco smoking, insufficient vitamin D levels and/or sun exposure have impacts on MS phenotypes and various markers of disease activity including relapse, disability progression and MRI findings. Clearly the effect of environmental factors on MS disease course is an area that requires significantly more research.


Publication title

Expert Review of Neurotherapeutics






Menzies Institute for Medical Research


Taylor & Francis

Place of publication

United Kingdom

Rights statement

© 2021 Informa UK Limited, trading as Taylor & Francis Group

Repository Status

  • Restricted

Socio-economic Objectives

Diagnosis of human diseases and conditions; Prevention of human diseases and conditions

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