Exposure to infant siblings during early life and risk of multiple sclerosis |
| |
Authors: | Ponsonby Anne-Louise van der Mei Ingrid Dwyer Terence Blizzard Leigh Taylor Bruce Kemp Andrew Simmons Rex Kilpatrick Trevor |
| |
Institution: | National Centre for Epidemiology and Population Health, The Australian National University, Canberra ACT, Australia. anne-louise.ponsonby@anu.edu.au |
| |
Abstract: | Context The "hygiene hypothesis" has implicated sibship as a marker of infection load during early life and suggests that exposure or reexposure to infections can influence the developing immune system. Viral infection has also been implicated in the pathogenesis of multiple sclerosis (MS). Objectives To evaluate whether exposure to infant siblings in early life is associated with the risk of MS, and to explore the possible mechanism for any apparent protective effect, including altered Epstein-Barr virus (EBV) infection patterns. Design, Setting, and Patients Population-based case-control study in Tasmania, Australia, from 1999 to 2001 based on 136 cases of magnetic resonance imagingconfirmed MS and 272 community controls, matched on sex and year of birth. Main Outcome Measure Risk of MS by duration of contact with younger siblings aged less than 2 years in the first 6 years of life. Results Increasing duration of contact with a younger sibling aged less than 2 years in the first 6 years of life was associated with reduced MS risk (adjusted odds ratios AORs]: <1 infant-year, 1.00 reference]; 1 to <3 infant-years, 0.57 95% confidence interval {CI}, 0.33-0.98]; 3 to <5 infant-years, 0.40 95% CI, 0.19-0.92]; 5 infant-years, 0.12 95% CI, 0.02-0.88]; test for trend, P = .002). A history of exposure to infant siblings was associated with a reduced IgG response to EBV among controls. Controls with at least 1 infant-year contact had a reduced risk of infectious mononucleosis and a reduced risk of very high composite EBV IgG titers (AOR, 0.33; 95% CI, 0.11-0.98) compared with other controls. The inverse association between higher infant contact and MS was independent of EBV IgG titer. Conclusion Higher infant sibling exposure in the first 6 years of life was associated with a reduced risk of MS, possibly by altering childhood infection patterns and related immune responses. |
| |
Keywords: | |
本文献已被 PubMed 等数据库收录! |
| 点击此处可从《The Journal of the American Medical Association》浏览原始摘要信息 |
| 点击此处可从《The Journal of the American Medical Association》下载免费的PDF全文 |
|