Lifestyle factors may reduce or fuel inflammation in early MS, study says
Vitamin D, sunlight may be beneficial, while smoking could cause damage
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Lifestyle factors may impact inflammation in people with newly diagnosed multiple sclerosis, according to a study. (Photo from iStock)
- Lifestyle factors may significantly impact immune inflammation in early multiple sclerosis.
- Smoking and higher body weight may promote inflammatory immune profiles.
- Vitamin D and sunlight exposure may reduce inflammation.
Smoking and higher body weight may push the immune system toward a more inflammatory profile in people with newly diagnosed multiple sclerosis (MS), while vitamin D and sunlight appear to be linked to less inflammation, a German study found.
The findings overall “elucidate the molecular mechanisms by which modifiable risk factors contribute to MS,” researchers wrote, noting that the data support the implementation of healthy lifestyle changes alongside standard treatment for MS management.
The study, “Distinct Multiomic Signatures of Environmental Exposure Drive Immune Dysregulation and Disease Activity in Early Multiple Sclerosis,” was published in Neurology Neuroimmunology & Neuroinflammation.
Inflammation-related genes less active in those with more UV exposure
Symptoms of MS occur when the immune system mistakenly attacks healthy parts of the brain and spinal cord, causing inflammation. What exactly drives the disease is unclear, but studies suggest it arises from a combination of genetic and environmental factors.
In the recent study, scientists aimed to learn more about how some of these environmental factors may affect immune function early in the MS disease course. The analysis included 96 adults with newly diagnosed MS who had never received a disease-modifying treatment. They had a median age of 31, and most (74%) were women.
Participants completed various questionnaires about environmental and lifestyle factors. Blood samples were collected from each participant, which scientists used to identify changes in immune cells. They performed a comprehensive set of analyses to examine immune cell composition and cell-to-cell communication, as well as protein levels and gene activity across different immune cell populations.
Most participants (77%) had vitamin D deficiency, defined as blood levels below 20 ng/mL. Low vitamin D, which is produced naturally in the skin upon exposure to sunlight, is linked to a higher risk of developing MS and more severe symptoms.
Higher vitamin D levels and greater exposure to ultraviolet (UV) radiation from sunlight were both linked to reduced signs of inflammation, although UV exposure appeared to be associated with a broader anti-inflammatory signature.
People who had active inflammatory brain lesions at the time of their diagnosis had higher activity of two inflammation-related genes — IFI30 and LYZA — and the same genes were less active in people with greater UV exposure.
Smoking may encourage immune cells to become more inflammatory
Although smoking was uncommon in the study population, it was linked to increased activity of the GPR15 gene in all but one of the six immune cell types studied. GPR15 encodes a protein that guides immune cells to sites of inflammation. This increased gene activity was linked to greater MS-related disability.
Smoking was also associated with various other inflammation-related changes, including elevations in CXCL17 and LAMP3, two signaling proteins involved in immune cell movement and activation.
These findings suggest that smoking encourages immune cells to become more inflammatory and to move into tissues where they may contribute to MS, according to the authors.
Obesity has also been linked to MS development and progression, and nearly half (42%) of participants were overweight, defined as a body mass index (BMI) over 25.
BMI was associated with several immune and metabolic changes, particularly in cells called monocytes. The monocytes of patients with higher BMI showed increased activity of MVD and SQLE, two genes involved in producing cholesterol, a fat molecule that immune cells use for inflammatory signaling.
These insights strongly support the integration of lifestyle interventions as a core component of early MS management.
Higher BMI was associated with increased levels of inflammatory proteins, such as FABP4, which has been previously linked to more severe symptoms and disability in MS. Patients with higher BMI also had more myeloid dendritic cells, which are involved in activating immune responses.
Other analyses showed that a higher BMI was associated with weaker cell-to-cell communication between monocytes. On the other hand, alcohol consumption was linked to stronger communication among several immune cell types.
Overall, the findings identify body weight, smoking, vitamin D, and sun exposure as factors that could be modified to change the disease trajectory in people with newly diagnosed MS.
“These insights strongly support the integration of lifestyle interventions as a core component of early MS management,” the researchers wrote. They noted, however, that translating the findings into “actionable clinical guidance” will require pinpointing exactly how these factors should be modified.
For example, in the case of smoking, it appears that reducing smoking won’t be enough to truly change the disease course — completely quitting is probably needed. On the other hand, any incremental weight loss in an overweight or obese person might help reduce immune-related changes and be of clinical benefit.
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