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Multiple Sclerosis Risk Factors in Children

In children, an initial attack of demyelination (acquired demyelinating syndrome [ADS] in the central nervous system) often remains a single, isolated episode. However, in at least 20 % of children it represents the first clinical attack of MS. This contrasts with adult-onset MS, where most individuals presenting with acute demyelination are subsequently diagnosed with MS. Demyelination is the destructive loss of myelin – the protective covering that insulates and supports nerve cells – damaging the cells’ ability to receive and transmit signals in the body.
“The uncertainty of the diagnosis understandably creates a lot of anxiety for children and their families,” says Dr. Amit Bar-Or, neurologist and lead investigator at The Montreal Neurological Institute and Hospital – The Neuro, McGill University. “Having the tools to distinguish ADS and MS is important.” Researchers at The Neuro in collaboration with researchers at the SickKids in Toronto and international colleagues therefore wanted to identify the risk factors in the 20% of children who go on to develop MS, and to investigate if the risk factors and the disease biology are the same in both children and adults.
In adults, complex interactions between genetic and environmental factors contribute to risk and the best established genetic susceptibility marker has been identified in the alleles of the major histocompatability complex, a family of genes that play an important role in the immune system and autoimmunity. Specifically, the genetic risk factor for adults of northern European origins is localized to a form of the gene known as the HLA-DRB1 allele. The researchers wanted to verify if this allele predicts MS in at-risk children with ADS. Children, aged 16 or younger (266 children with ADS and 196 healthy controls) provided blood samples for genetic analysis.
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