학술논문

Pediatric Multiple Sclerosis: Genes, Environment, and a Comprehensive Therapeutic Approach.
Document Type
Journal Article
Source
Pediatric Neurology. Oct2017, Vol. 75, p17-28. 12p.
Subject
*MULTIPLE sclerosis
*MULTIPLE sclerosis diagnosis
*ULTRAVIOLET radiation
*OBESITY
*CHROMOSOMES
*PATIENTS
*MULTIPLE sclerosis treatment
*ECOLOGY
*PEDIATRICS
*ENVIRONMENTAL exposure
*SEQUENCE analysis
*CHILDREN
Language
ISSN
0887-8994
Abstract
Background: Pediatric multiple sclerosis is an increasingly recognized and studied disorder that accounts for 3% to 10% of all patients with multiple sclerosis. The risk for pediatric multiple sclerosis is thought to reflect a complex interplay between environmental and genetic risk factors.Main Findings: Environmental exposures, including sunlight (ultraviolet radiation, vitamin D levels), infections (Epstein-Barr virus), passive smoking, and obesity, have been identified as potential risk factors in youth. Genetic predisposition contributes to the risk of multiple sclerosis, and the major histocompatibility complex on chromosome 6 makes the single largest contribution to susceptibility to multiple sclerosis. With the use of large-scale genome-wide association studies, other non-major histocompatibility complex alleles have been identified as independent risk factors for the disease. The bridge between environment and genes likely lies in the study of epigenetic processes, which are environmentally-influenced mechanisms through which gene expression may be modified.Conclusions: This article will review these topics to provide a framework for discussion of a comprehensive approach to counseling and ultimately treating the pediatric patient with multiple sclerosis. [ABSTRACT FROM AUTHOR]