Racial difference in MS distribution and severity

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Racial difference in MS distribution and severity

Postby TwistedHelix » Wed Jul 04, 2007 6:16 am

I hadn't heard of this before, but it's another incongruity in the distribution of MS:



Public release date: 2-Jul-2007
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Contact: Michael C. Purdy
purdym@wustl.edu
314-286-0122
Washington University School of Medicine

Antibody linked to MS significantly higher in spinal fluid of blacks
St. Louis — An antibody frequently used as a diagnostic marker for multiple sclerosis (MS) is present at greater levels in the cerebrospinal fluid of blacks with MS than Caucasians with the disease. The findings suggest that genetic differences among ethnic groups contribute to changes in the immune system, affecting susceptibility to MS. And they add another piece to a tantalizing but stubborn puzzle: Why do blacks get MS less often than other ethnic groups but suffer more serious symptoms when they develop the disease"

"These antibodies are indicators of inflammation, but we don't yet understand how inflammation is linked to prognosis," says first author John R. Rinker II, M.D., who did the work as a fellow at Washington University School of Medicine in St. Louis and is now assistant professor of neurology at the University of Alabama at Birmingham. "No one really understands yet why inflammation levels differ from one MS patient to the next."

The new study measured cerebrospinal fluid levels of IgG, an immune system antibody. Rinker and others have previously linked greater IgG to more aggressive MS in the general patient population. But that same link could not be reestablished in the new study, which assessed disease severity by comparing the time from MS diagnosis to when the patient first needed assistance walking. Black patients needed help walking sooner — an average of nine years after diagnosis versus 17 years for Caucasians — but on a case-by-case basis, scientists couldn't use greater IgG to predict an earlier need for assistance in walking.

"It may be that we haven't yet focused on the right disease characteristic or milestone in our search for factors that correlate with spinal inflammation," says Rinker. "I'm hoping to expand the search for correlations in follow-up studies."

The results are published in the July 3 issue of Neurology.

Epidemiologists estimate that 400,000 people in the United States have MS. Symptoms, which often strike in episodic bursts, include bladder and bowel dysfunction, memory problems, fatigue, dizziness, depression, difficulty walking, numbness, pain and vision problems. The disease is more common among Caucasians than any other group and affects two to three times as many women as men.

Research has shown that genetic factors contribute to MS risk but are not the sole determining factor. Scientists believe MS is likely triggered by a bacterial or viral infection. The infection causes an abnormal response in the immune system that misdirects the body's defenses against myelin, a protective sheath that surrounds many nerve cells.

To help clinch a diagnosis of MS, clinicians often test the spinal fluid for elevated levels of IgG. Since everyone makes IgG as a part of normal immune function, scientists have to assess cerebrospinal IgG levels using an index that also factors in the amount of IgG in the patient's blood and the integrity of the blood-brain barrier, which limits access to the brain.

"High IgG levels in a healthy person's bloodstream can cause this antibody to seep over into the cerebrospinal fluid, so a high level of spinal IgG isn't by itself very revealing," explains senior author Anne Cross, M.D., professor of neurology and head of the neuroimmunology section. "What's different in MS patients is that they make IgG in the central nervous system. We can determine that this is the case by using the IgG index."

Working at the John L. Trotter MS Center at Washington University, Rinker analyzed samples from 66 black patients with MS and 132 Caucasians with the disease. According to the index, blacks' IgG levels were 29 percent higher. Study coauthor Rob Naismith, M.D., and others have previously shown that while blacks develop MS less frequently, the consequences are often more serious.

"Lower access to care and to medication may contribute to this effect, but apart from those potential contributing factors, African Americans with MS still seem to have more aggressive forms and suffer more disability," Cross says.

###
Rinker JR II, Trinkaus K, Naismith RT, Cross AH. Higher IgG index found in African Americans versus Caucasians with multiple sclerosis. Neurology, July 3, 2007.

Funding from the National Institutes of Health and the National Multiple Sclerosis Society supported this research.

Washington University School of Medicine's full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.



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Re: Racial difference in MS distribution and severity

Postby Lyon » Thu Jul 05, 2007 4:00 pm

TwistedHelix wrote: Why do blacks get MS less often than other ethnic groups but suffer more serious symptoms when they develop the disease"
Hi Dom,
I swear that when I started studying MS I had seen evidence that Multiple Sclerosis was more optically oriented and aggressive when Americans first began experiencing it. I've been looking for the last two days but can't find documentation.

Recently I've seen information that African/Americans are experiencing more optically oriented and aggressive MS,
the Japanese are experiencing more optically oriented and aggressive MS and
the American Indians are experiencing more optically oriented and aggressive MS than caucasians.

As someone who is convinced in the hygiene hypothesis what might I be considered to make of that information, if there's any truth to it?

Using "electricity, running water and flush toilets" as the definition of "developed", Japan is a latecomer to the "developed" world and has begun to experience a rise in MS much later than the rest of us.

Considering the living conditions the American Indians have had to endure it might be said that, using the above definition, by and large they still aren't part of the "developed" world.

Although African/Americans have made headway in recent history, by the above definition, a sizable percentage of their population still live in squalor.

African/Americans and American Indians are only recently experiencing MS. Only a percentage live in "developed" conditions and therefore are eligible for the MS lottery so I don't find it surprising that their incidence numbers are low.

"IF" the information showing that populations only recently experiencing MS are experiencing more optically oriented and aggressive as "we" did ("IF" it's true that we did) which gets progressively less optically oriented and aggressive with time...........I don't know what that would mean but it must hold some kind of valuable lesson.

It seems it should raise more curiousity that the populations which have continued to stun researchers, due to the fact that MS is absent from their populations despite their often living at the same latitudes and often sharing genetics with populations with very high MS incidence. The one thing those populations all share in common and also share in common with the people around the equator who seldom experience MS is that they often live in close quarters, live closer to the land than we do (food isn't painstakingly sterile, as ours is) they have no experience with vaccinations or antibiotics and they don't have electricity, running water or flush toilets.
(I can't remember the whole list but it includes the Sami, Eskimos, Australian Aborigines, etc..)

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Ethnic group differences in prevalence

Postby lyndacarol » Thu Jul 05, 2007 5:16 pm

Lyon--Among the other groups, you wrote:
(I can't remember the whole list but it includes the Sami, Eskimos, Australian Aborigines, etc..)


I understand your emphasis on "sanitation," but diets different from those in developed countries seem to me to be a greater variable with more influence.

I saw a PBS program (Frontline) last week that featured the Faroe Islands and their tradition of hunting and eating pilot whales. Maybe the British troops stationed there during WWII introduced different foods that contributed to the arrival of MS on the islands (where the earlier diet discouraged it).
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Re: Ethnic group differences in prevalence

Postby Lyon » Thu Jul 05, 2007 7:45 pm

lyndacarol wrote: I saw a PBS program (Frontline) last week that featured the Faroe Islands and their tradition of hunting and eating pilot whales. Maybe the British troops stationed there during WWII introduced different foods that contributed to the arrival of MS on the islands (where the earlier diet discouraged it).
Hi Lynda,
You bring up a good point Lynda in that the "environmental" factors which separate developed from undeveloped populations could be a lot of things. Any external thing affecting the body including food, toxins, and almost an endless list of others.

Reading that book about the history of MS the other night made me realize that the search for the cause of MS was a lot longer and a lot more extensive than most of us suspect. In that time literally everything known to man has been tried against MS to no avail, diet probably more than anything.

The only thing not known to man, or at least not considered, was the loss of the parasites we shared evolution with and which had been modifying our immune systems to insure their survival.

I wish I would have seen that Frontline show but partly because of an earlier conversation that you and I had, I've studied the living conditions and diet of the Faroese a lot and also questioned a parasitologist friend who works with the Danish Centre for Experimental Parasitology (the Faroese have been beneficiaries of the Danish medical system and their record keeping for quite some time).

I told her that Dr Kurtzke had said there was no reason to consider either the absence or presences of parasites on the Faroes as a factor in MS incidence and she told me that in Northern Europe Zoonotic parasites have always been more of a factor than the parasites we normally consider as being adapted to humans.

Not only are the pilot whales (highly parasitized) and other seafood on the Faroe diet but also fulmars (highly parasitized), which are a type of seabird. Additionally,

the Faroese dry their food as a preservation method. Drying does nothing to kill parasites and their eggs.

It's only logical that Faroese were/are infested with zoonotic parasites but what the British occupation had to do with the (temporarily) non-traditional diet of the Farose? I have no idea.

Bob

Thank you Lynda! I'm so glad you mentioned that show. This is the Frontline site and it has video! http://www.pbs.org/frontlineworld/stories/faroe605/
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Postby TwistedHelix » Fri Jul 06, 2007 7:15 am

That video is very interesting but be warned: some of the whaling scenes are pretty graphic!
I'm becoming increasingly convinced that our modern, westernised lifestyle is a whole cocktail of things which are bad for our health: it's not just diet; it's not just sanitation; it's not just toxins in our environment; it's not just medication, it's a vast catalogue of things, some of which shouldn't be there but are, some of which should be there but are missing.
Bob and I have recently been discussing the role of stress in illness, in light of recent discoveries that the human body has a different response to different types of stress. For instance, the reaction to sudden, violent threat is less harmful on a physiological level than the constant low grade, niggling, gnawing anxiety which is a common experience for " modern" cultures. Just another thing to throw into the mix.
One question, Bob, I've just been wondering what you think has been the effect of repeatedly deworming cattle, if any?
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Postby Lyon » Fri Jul 06, 2007 8:30 am

TwistedHelix wrote: One question, Bob, I've just been wondering what you think has been the effect of repeatedly deworming cattle, if any?
Hi Dom,
The effect regarding the health of the cattle themselves or the effect on us in consuming those cattle? I guess it's a moot point anyway because I'm not aware of anyone ever looking into that question, although at this point in time it seems like a valid question.

The closest I've come to that answer (not very close!) was about a year ago I read an off the cuff comment in which the researcher said that previously unseen autoimmune diseases were also being noticed in our domestic animals and speculated that it was due to our vaccinating them and deworming, etc... I've never seen specific studies....then again, I haven't looked.

Case in point is that historically the vast majority of funding, research and knowledge gained regarding parasites was aimed toward our domestic animals....how to more effectively rid them of parasites.

That's how it happened to be noticed that parasites modulate the immune system of the host as a survival mechanism. Researchers noticed the effect and were/are investigating the possibility that this could be exploited as an effective means of ridding the host of parasites. In other words, if the immune modulation techniques of the parasites could be circumvented, the host's immune system would notice the presences of those parasites and eliminate them on it's own.

Viruses, bacteria, helminths and other parasites don't exist in us because our system is incapable of killing them but because they have evolved to pull tricks on our immune system.

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