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Published on: October 13, 2023
Genetic and environmental mediators of multiple sclerosis susceptibility but not early severity run in families
Cato E A Corsten1, Ana M Marques2, Yifan van Hasselt2
1Department of Neurology, MS Center ErasMS, Erasmus MC University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
Background:
Multiple sclerosis (MS) susceptibility and severity are mediated by different genetic and environmental risk factors. Familial aggregation in MS is partially explained by susceptibility determinants, yet impact on early disease course after clinically isolated syndrome (CIS) is uncertain. We investigated associations of reported familial MS with genetic and environmental risk factors, and with clinical presentation and disease course after CIS.
Methods:
CIS participants were included in a prospective cohort within six months after symptom onset. Family history was assessed at baseline. We evaluated weighted genetic risk scores (wGRS) for MS susceptibility, 25-hydroxyvitamin D (25(OH)D) and body mass index (BMI), and determined HLA-DRB1*15:01 and MS severity SNP rs10191329 carriership. Anti-Epstein Barr virus Nuclear Antigen-1 (anti-EBNA1) IgG antibodies and 25(OH)D levels were measured. Disease course associations were estimated with Cox regression.
Results:
Family members with MS were reported by 81/415 (19.5%) CIS participants. Familial MS was associated with higher MS susceptibility wGRS (7.54 (SD1.17) vs. 7.19 (SD1.22), p=0.04) and more frequent HLA-DRB1*15:01 carriership (first-degree 66.7%, other-degree 30.2%, no 38.4%, p=0.02). Anti-EBNA1 IgG and 25(OH)D levels did not differ, yet wGRS for lower 25(OH)D and higher adult BMI characterised MS participants with first-degree MS relatives. Baseline characteristics and disease severity measures were similar between participants with and without familial MS.
Conclusion:
Our results confirm that familial MS is associated with enrichment of genetic risk for MS susceptibility, low 25(OH)D and high BMI, but not with early disease course after CIS. These data support that MS susceptibility and disease course are driven by different pathophysiological processes.
Insights
Familial multiple sclerosis (MS) is linked to genetic susceptibility, low vitamin D, and high BMI, but does not affect the early disease course after clinically isolated syndrome (CIS). These factors influence MS risk, not progression.
Area of Science:
- Neurology
- Genetics
- Immunology
Background:
- Multiple sclerosis (MS) risk involves genetic and environmental factors.
- Familial aggregation of MS is known, but its impact on early disease progression after clinically isolated syndrome (CIS) remains unclear.
Purpose of the Study:
- To investigate the association of familial MS with genetic and environmental risk factors.
- To examine the relationship between familial MS and the clinical presentation and disease course following CIS.
Main Methods:
- A prospective cohort study of CIS participants within six months of symptom onset.
- Assessment of family history, weighted genetic risk scores (wGRS) for MS, 25-hydroxyvitamin D (25(OH)D), body mass index (BMI), HLA-DRB1*15:01, and anti-Epstein Barr virus Nuclear Antigen-1 (anti-EBNA1) IgG.
- Cox regression analysis to estimate associations with disease course.
Main Results:
- Familial MS was reported by 19.5% of participants and associated with higher MS susceptibility wGRS and HLA-DRB1*15:01 carriership.
- Participants with first-degree relatives with MS showed wGRS for lower 25(OH)D and higher adult BMI.
- No significant differences in anti-EBNA1 IgG, 25(OH)D levels, baseline characteristics, or disease severity were observed between familial and non-familial MS groups.
Conclusions:
- Familial MS is linked to increased genetic susceptibility, lower vitamin D, and higher BMI.
- These factors are associated with MS risk but not with the early disease course after CIS.
- MS susceptibility and disease course appear to be influenced by distinct pathophysiological pathways.
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