Articles
 

The Relation of Multiple Sclerosis with Allergy and Atopy: A Case Control Study

Abstract

Multiple Sclerosis (MS) and Allergy are believed to up regulate T helper cell type 1 (Th1) and T helper cell type 2 (Th2) responses, respectively. It has been shown that disequilibrium in the  ratio  of  Th1/Th2  activities may increase frequency of  one  disease and  decrease the frequency of the other. The aim of this study was to investigate the relation of MS with allergy and atopy in new diagnosed MS patients.
This case-control study was conducted on 40 new diagnosed MS patients and the same number  of  normal controls. All of  the  patients were diagnosed (according to  McDonald criteria) at most 2 years prior to the study. Demographic data and clinical characteristics of both groups were recorded in a questionnaire. The total IgE and allergen specific IgE in the serum were measured in all the cases.
Forty MS patients (female/male: 4.71) with mean age of 30.55±9.5 years and 40 healthy controls entered in this study. History of allergy was observed in 20(50%) of MS patients (including 15 (37.5%) rhinitis, 6 (15%) conjunctivitis, 3 (7.5%) urticaria and eczema, 1 (2.5%) asthma), and 20 (50%) of the controls (including 8 (20%) rhinitis, 4 (10%) conjunctivitis, 7 (17.5%) urticaria and eczema, 1 (2.5%) asthma). The differences between the two groups were not  statistically significant. Neither the serum total IgE, nor the frequency of specific IgE against Weed mix, Grass Mix, Tree mix1, Tree mix 2, Dermatophagoides Farinae, Dermatophagoides pteronyssinus and Epidermal and animal proteins mix differed statistically between the  two  groups. There  was also no  significant relationship between MS clinical manifestations and allergy prevalence and also between MS and atopy.
 The results of this study as some other similar studies showed the same prevalence of allergy in MS patients and controls and also demonstrated no relation between MS and atopy.

1. Jackson SJ, Lee JE, Nikodemova M, Fabry Z, Duncan ID.Quantification of myelin and axon pathology during relapsing progressive experimental autoimmune encephalomyelitis in the Biozzi ABH mouse. J Neuropathol Exp Neurol 2009; 68(6):616-25.
2. Ghandehari K, Riasi HR, Nourian A, Boroumand AR.Prevalence of multiple sclerosis in north east of Iran. Mult Scler 2010; 16(12):1525-6.
3. Etemadifar M, Maghzi AH. Sharp increase in the incidence and prevalence of multiple sclerosis in Isfahan, Iran. Mul Scler 2011; 17(8):1022-7.
4. Kim SE. Daclizumab treatment for multiple sclerosis.Pharmacotherapy 2009; 29(2):227-35.
5. Friese MA, Fugger L. Pathogenic CD8+ T cells in multiple sclerosis. Ann Neurol 2009; 66(2):132-41.
6. Ingram G, Hakobyan S, Robertson N, Morgan BP.Complement in multiple sclerosis: its role in disease and potential as a biomarker. Clin Exp Immunol 2009;155(2):128-39.
7. McFarland HF, Martin R. Multiple sclerosis: a complicated picture of autoimmunity. Nat Immunol 2007;8(9):913-9.
8. Giovannoni G, Ebers G. Multiple sclerosis: the environment and causation. Curr Opin Neurol 2007;20(3):261.
9. Evans J, Rogers C, Wiles CM, Luscombe DK, Tremlett HL. General practitioners' prescribing data for multiple sclerosis patients indicates a link with asthma. Br J Gen Pract 2000; 50(453):323.
10. Navikas V, Link H. Review: cytokines and the pathogenesis of multiple sclerosis. J Neurosci Res 1996;45(4):322-33.
11. Singh VK, Mehrotra S, Agarwal SS. The paradigm of Th1 and Th2 cytokines: its relevance to autoimmunity and allergy. Immunol Research 1999; 20(3):147-61.
12. Miri S, Farid R, Akbari H, Amin R. Prevalence of allergic rhinitis and nasal smear eosinophilia in 11‐to 15 yr‐old children in Shiraz. Pediat Allergy Immunol 2006;17(7):519-23.
13. Bazzazi H, Gharagozlou M, Kassaiee M, Parsikia A, Zahmatkesh H. The prevalence of asthma and allergic disorders among school children in Gorgan. J Res Med Scienc 2007; 12(1):28-33.
14. Varasteh AR, Fereidouni M, Shakeri MT, Vahedi F, Abolhasani A, Afsharian MS, et al. Prevalence of allergic disorders among the population in the city of Mashhad, Northeast Iran. J Public Health 2009; 17(2):107-12.
15. Kay A. Allergy and allergic diseases. Second of two parts. N Eng J Med 2001; 344(2):109.
16. Kidd P. Th1/Th2 balance: the hypothesis, its limitations, and implications for health and disease. Altern Med Rev 2003; 8(3):223-46.
17. Klemens C, Rasp G, Jund F, Hilgert E, Devens C, Pfrogner E, et al. Mediators and cytokines in allergic and viral-triggered rhinitis. Allergy Asthma Pro 2007;28(4):434-41.
18. Tesmer LA, Lundy SK, Sarkar S, Fox DA. Th17 cells in human disease. Immunol Rev 2008; 223(1):87-113.
19. Iwakura Y, Nakae S, Saijo S, Ishigame H. The roles of IL‐17A in inflammatory immune responses and host defense against pathogens. Immunol Rev 2008;226(1):57-79.
20. Komiyama Y, Nakae S, Matsuki T, Nambu A, Ishigame H, Kakuta S, et al. IL-17 plays an important role in the development of experimental autoimmune encephalo- myelitis. J Immunol 2006; 177(1):566-73.
21. Kasper LH, Shoemaker J. Multiple sclerosis immunology: The healthy immun system vs the MS immun system. Neurology 2010; 74(1 Supplement 1):S2-8.
22. Pedotti R, DeVoss JJ, Steinman L, Galli SJ. Involvement of both allergic'and autoimmune'mechanisms in EAE, MS and other autoimmune diseases. Trends Immunol 2003;24(9):479-84.
23. Costantino CM, Baecher-Allan C, Hafler DA. Multiple sclerosis and regulatory T cells. J clin Immunol 2008;28(6):697-706.
24. Alonso A, Hernan M, Ascherio A. Allergy, family history of autoimmune diseases, and the risk of multiple sclerosis. Acta Neurol Scand 2008; 117(1): 15-20.
25. Sospedra M, Martin R. Immunology of multiple sclerosis.Annu Rev Immunol 2005; 23:683-747.
26. Rudwaleit M, Andermann B, Alten R, Sörensen H, Listing J, Zink A, et al. Atopic disorders in ankylosing spondylitis and rheumatoid arthritis. Ann Rheum Dis 2002; 61(11):968-74.
27. Airaghi L, Tedeschi A. Results of the US Third National Health and Nutrition Examination Survey support the hygiene hypothesis. J Allergy Clin Immunol 2004;113(1):179-80.
28. Ponsonby AL, Dwyer T, Van Der Mei I, Kemp A, Blizzard L, Taylor B, et al. Asthma onset prior to multiple sclerosis and the contribution of sibling exposure in early life. Clin Exp Immunol 2006;146(3): 463-70.
29. Edwards L, Constantinescu C. A prospective study of conditions associated with multiple sclerosis in a cohort of 658 consecutive outpatients attending a multiple sclerosis clinic. Multiple sclerosis 2004;10(5):575-81.
30. Solaro C, Messmer UM, Guglieri P, Murialdo A, Sormani MP, Battaglia MA, et al. Prevalence of atopy in multiple sclerosis patients: a case-control study. J Neurol 2001;248(3):239-40.
31. Neukirch F, Lyon-Caen O, Clanet M, Bousquet J, Feingold J, Druet P. Asthma, nasal allergies, and multiple sclerosis. J Allergy Clin Immunol 1997; 99(2):270-1.
32. Pedotti R, Farinotti M, Falcone C, Borgonovo L,Confalonieri P, Campanella A, et al. Allergy and multiple sclerosis: a population-based case-control study. Multiple sclerosis 2009; 15(8):899-906.
33. Alonso A, Jick SS, Hernán MA. Allergy, histamine 1 receptor blockers, and the risk of multiple sclerosis. Neurology 2006; 66(4):572-5.
34. Monteiro L, Souza‐Machado A, Menezes C, Melo A.Association between allergies and multiple sclerosis: a systematic review and meta‐analysis. Acta Neurol Scand 2011; 123(1):1-7.
35. Tang L, Benjaponpitak S, DeKruyff RH, Umetsu DT.Reduced prevalence of allergic disease in patients with multiple sclerosis is associated with enhanced IL-12 production. J Allergy Clin Immunology 1998;102(3):428-35.
36. Bergamaschi R, Villani S, Crabbio M, Ponzio M, Romani A, Verri A, et al. Inverse relationship between multiple sclerosis and allergic respiratory diseases. Neurol Sci 2009; 30(2):115-8.
37. Ramagopalan SV, Dyment DA, Guimond C, Orton SM, Yee IM, Ebers GC, et al. Childhood cow's milk allergy and the risk of multiple sclerosis: A population based study. J Neurol Sci 2010; 291(1):86-8.
38. McDonald WI, Compston A, Edan G, Goodkin D,Hartung HP, Lublin FD, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 2001; 50(1):121-7.
39. Durham SR, Church MK. Principles of allergy diagnosis.In: Holgate ST, Church MK, Lichtenstein LM, eds. Allergy, 2nd London: Mosby, 2001:3–16.
40. Bush RK. Approach to patients with symptoms of food allergy. Am J Med 2008; 121(5): 376-8.
41. Sly PD, Boner AL, Björksten B, Bush A, Custovic A, Eigenmann PA, et al. Early identification of atopy in the prediction of persistent asthma in children. Lancet 2008;372(9643):1100-6.
42. Tremlett H, Evans J, Wiles CM, Luscombe DK. Asthma and multiple sclerosis: an inverse association in a case‐control general practice population. Qjm 2002;95(11):753-6.
43. Oro AS, Guarino TJ, Driver R, Steinman L, Umetsu DT.Regulation of disease susceptibility: decreased prevalence of IgE-mediated allergic disease in patients with multiple sclerosis. J Allergy Clin Immunol 1996; 97(6):1402-8.
44. Kira J, Kawano Y, Yamasaki K. Multiple sclerosis with mite antigen-specific IgE. J Neurol Sci 1998; 157(2):138-42.
45. Bach JF. The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med 2002;347(12):911-20.
46. Waubant E, Mowry EM, Krupp L, Chitnis T, Yeh EA, Kuntz N, et al. Common viruses associated with lower pediatric multiple sclerosis risk. Neurology 2011;76(23):1989-95.
47. Canradi S, Malzahn U, Schroter F, Paul F, Quill S, Spruth E, et al. Environmental factors in early childhood are associated with multiple sclerosis: a case-control study. BMC Neurol 2011; 11:123.
48. Leibowitz U, Antonovsky A, Medalie J, Smith HA,Halpern L, Alter M. Epidemiological study of multiple sclerosis in Israel. II. Multiple sclerosis and level of sanitation. J Neurol Neurosurg Psychiatry 1966; 29(1):60-8.
49. Levin LI, Munger KL, Rubertone MV, Peck CA, Lennette ET, Spiegelman D, et al. Multiple sclerosis and Epstein-Barr virus. JAMA 2003; 289(12):1533-6.
50. Ponsonby AL, van der Mei I, Dwyer T, Blizzard L, Taylor B, Kemp A, et al. Exposure to infant siblings during early life and risk of multiple sclerosis. JAMA 2005; 293(4):463-9.

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IssueVol 12, No 2 (2013) QRcode
SectionArticles
Keywords
Allergy Atopy Multiple Sclerosis Immunoglobulin E

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1.
Karimi P, Modarresi SZ, Sahraian MA, Shokouhi Shoormasti R, Mahlooji M, Kazemnejad A, Pourpak Z. The Relation of Multiple Sclerosis with Allergy and Atopy: A Case Control Study. Iran J Allergy Asthma Immunol. 1;12(2):182-189.