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Asthma and multiple sclerosis: an inverse association in a case-control general practice population
H L Tremlett1, J Evans, C M Wiles
1Department of Medicine (Neurology), University of Wales College of Medicine, Cardiff, Wales, UK. tremlett@interchange.ubc.ca
QJM : Monthly Journal of the Association of Physicians
|October 23, 2002
Summary
Multiple sclerosis (MS) shows an inverse relationship with asthma, suggesting a potential Th1/Th2 imbalance. This finding supports further investigation into immune system shifts for potential therapeutic targets in MS.
Area of Science:
- Immunology
- Neurology
- Epidemiology
Background:
- The Th1/Th2 immune balance is implicated in various diseases.
- Multiple sclerosis (MS), a Th1-mediated condition, has been anecdotally linked to a lower incidence of Th2-mediated allergies like asthma.
Purpose of the Study:
- To determine if MS is associated with a decreased risk of Th2-associated diseases.
- To investigate if MS is linked to an increased risk of Th1-associated diseases.
Main Methods:
- A retrospective matched case-control study design was employed.
- 320 MS patients and matched controls were analyzed using data from the Welsh General Practice Morbidity Database (1995-1999).
- Records were assessed for the presence of Th1- and Th2-mediated diseases.
Main Results:
- An inverse association was observed between MS and asthma (Odds Ratio [OR] 0.33, 95% Confidence Interval [CI] 0.15-0.77).
- No significant associations were found between MS and other Th2 diseases (eczema, dermatitis) or Th1 diseases (rheumatoid arthritis, thyroid disorders, type 1 diabetes).
- A trend for inflammatory bowel disease (IBD) was noted, with 5 cases and 0 controls (OR infinity, 95% CI 1.30-infinity, p=0.063).
Conclusions:
- The inverse association between MS and asthma supports the Th1/Th2 imbalance hypothesis.
- While the Th1/Th2 theory may be an oversimplification for MS, a shift towards Th2 dominance could offer novel therapeutic strategies.
- Further research into immune system modulation in MS is warranted.