TY - JOUR
T1 - Environmental Factors Associated with Disease Progression after the First Demyelinating Event
T2 - Results from the Multi-Center SET Study
AU - Horakova, Dana
AU - Zivadinov, Robert
AU - Weinstock-Guttman, Bianca
AU - Havrdova, Eva
AU - Qu, Jun
AU - Tamaño-Blanco, Miriam
AU - Badgett, Darlene
AU - Tyblova, Michaela
AU - Bergsland, Niels
AU - Hussein, Sara
AU - Willis, Laura
AU - Krasensky, Jan
AU - Vaneckova, Manuela
AU - Seidl, Zdenek
AU - Lelkova, Petra
AU - Dwyer, Michael G.
AU - Zhang, Ming
AU - Yu, Haoying
AU - Duan, Xiaotao
AU - Kalincik, Tomas
AU - Ramanathan, Murali
PY - 2013/1/8
Y1 - 2013/1/8
N2 - Objectives: To investigate the associations of environmental MS risk factors with clinical and MRI measures of progression in high-risk clinically isolated syndromes (CIS) after the first demyelinating event. Methods: We analyzed 211 CIS patients (age: 28.9±7.8 years) enrolled in the SET study, a multi-center study of high-risk CIS patients. Pre-treatment samples were analyzed for IgG antibodies against cytomegalovirus (anti-CMV), Epstein Barr virus (EBV) early nuclear antigen-1 (EBNA-1), viral capsid antigen (VCA), early antigen-diffuse (EA-D), 25 hydroxy-vitamin D3 and cotinine levels and HLA DRB1*1501 status. The inclusion criteria required evaluation within 4 months of the initial demyelinating event, 2 or more brain MRI lesions and the presence of two or more oligoclonal bands in cerebrospinal fluid. All patients were treated with interferon-beta. Clinical and MRI assessments were obtained at baseline, 6, 12, and 24 months. Results: The time to first relapse decreased and the number of relapses increased with anti-CMV IgG positivity. Smoking was associated with increased number and volume of contrast-enhancing lesions (CEL) during the 2-year period. The cumulative number of CEL and T2 lesions during the 2-year period was greater for individuals in the highest quartile of anti-EBV VCA IgG antibodies. The percent loss of brain volume was increased for those in the highest quartile of with anti-EBV VCA IgG antibodies. Conclusions: Relapses in CIS patients were associated with CMV positivity whereas anti-EBV VCA positivity was associated with progression on MRI measures, including accumulation of CEL and T2 lesions and development of brain atrophy.
AB - Objectives: To investigate the associations of environmental MS risk factors with clinical and MRI measures of progression in high-risk clinically isolated syndromes (CIS) after the first demyelinating event. Methods: We analyzed 211 CIS patients (age: 28.9±7.8 years) enrolled in the SET study, a multi-center study of high-risk CIS patients. Pre-treatment samples were analyzed for IgG antibodies against cytomegalovirus (anti-CMV), Epstein Barr virus (EBV) early nuclear antigen-1 (EBNA-1), viral capsid antigen (VCA), early antigen-diffuse (EA-D), 25 hydroxy-vitamin D3 and cotinine levels and HLA DRB1*1501 status. The inclusion criteria required evaluation within 4 months of the initial demyelinating event, 2 or more brain MRI lesions and the presence of two or more oligoclonal bands in cerebrospinal fluid. All patients were treated with interferon-beta. Clinical and MRI assessments were obtained at baseline, 6, 12, and 24 months. Results: The time to first relapse decreased and the number of relapses increased with anti-CMV IgG positivity. Smoking was associated with increased number and volume of contrast-enhancing lesions (CEL) during the 2-year period. The cumulative number of CEL and T2 lesions during the 2-year period was greater for individuals in the highest quartile of anti-EBV VCA IgG antibodies. The percent loss of brain volume was increased for those in the highest quartile of with anti-EBV VCA IgG antibodies. Conclusions: Relapses in CIS patients were associated with CMV positivity whereas anti-EBV VCA positivity was associated with progression on MRI measures, including accumulation of CEL and T2 lesions and development of brain atrophy.
UR - https://www.scopus.com/pages/publications/84872203150
U2 - 10.1371/journal.pone.0053996
DO - 10.1371/journal.pone.0053996
M3 - Article
C2 - 23320113
AN - SCOPUS:84872203150
SN - 1932-6203
VL - 8
JO - PLOS ONE
JF - PLOS ONE
IS - 1
M1 - e53996
ER -