A study reported in today’s BMJ confirms that multiple sclerosis is probably an epigenetic disease with in utero exposure to low vitamin D levels determining disease susceptibility in later life. Judith Staples and colleagues show that low maternal exposure to ultraviolet radiation in the first trimester of pregnancy is independently associated with subsequent risk of MS in their offspring in Australia. The adjusted incidence rate ratio for MS is 1.32 (95% confidence interval 1.10 to 1.58, P<0.01) for those subjects born in November or December compared with those born in May or June. As expected the inverse is observed in the Northern hemisphere. How exposure to low vitamin D levels in utero determines disease susceptibility is unknown but is clearly an area of major scientific interest and is being actively pursued by our group. The public health implications of these observations are profound and support the need for high-dose vitamin D supplementation in early pregnancy. In a collaborative study between Queen Mary University of London and Oxford University we are exploring this phenomenon further and would urge anyone with MS to complete our online survey.
Prof G,Just out of interest, what makes this study so significant (given that there has been numerous Vit D / MS research papers published over the last few years)?How might low Vit D in a pregnant woman lead to someone developing the desease 20/30/40 years later?What about the other triggers such as virus (e.g. EBV) that have been examined over the years. Might these still play a part?Is Vit D deficiency a cause or does it just make you susceptible if you run across another trigger?What does this research mean for current / future treatments?
Prof G,Does this put the final nail in the coffin for research into EAE / research on mice? I'm guessing that the Vit D deficiency in mothers angle isn't relevant to mice?
Prof G,Can fathers still pass MS to their children given this research?Why do we not see more MS cases in cultures where females / expectant mothers cover up (and must be Vit D deficient) e.g. Middle East?
A lot of questions all of which are highly relevant!This is not a new discovery, but it very significant as it confirms the importance of early life events set the stage for autoimmunity.The current thinking is that you need to early environment to put you at risk for later exposures that then trigger MS. I agree that mice become less relevant in terms of causation, but they are still a provide a great model to study specific mechanisms at play within the central nervous system. For example, how does inflammation cause neuronal loss.This study goes some way to explain the dearth of father to child transmission of MS.
I was born in Norwich Norfolk 1952, from the age of about 6 I had sun ray treatment twice weekly at the local hospital as my gp thought I was always pale and tired. He thought some sunlight may be beneficial. I was diagnosed with MS in 1995 although I did have some symptoms some years before that. I hope this may be relevant to your theory.