What is it about smoking an MS? #ResearchSpeak #MSBlog #MSResearch
"The study below on smoking and regional brain volume, or atrophy, is ambiguous. It suggest that in early MS, CIS, smoking may have neuroprotective effects. As this study is small it will need to be reproduced. At present my message remains the same:
'Smoking increases your chances of getting MS by about 50%. MSers who are smokers do worse in the long-term compared to MSers who are non-smokers'."
"How smoking triggers MS and increases the rate of MS disease progression is unknown. In relation to causation some suggest it alters antigens, or proteins, via a process of post-translational modification that then triggers an autoimmune reaction against these altered protein. This has now been shown to occur in rheumatoid arthritis, hence it is not scientific fantasy. How smoking increases the rate of disease progression may be via several mechanisms. Smokers have revved-up immune systems, which may drive focal inflammatory events. Smokers are more likely to get recurrent respiratory tract infections; the infections may then drive MS disease activity. Smoking is a risk factor for cardiovascular disease; MSers with vascular disease do worse than those without. Hence the link may be indirect via comorbidities. Smokers are also less able to exercise consistently; may be the link is via less exercise. Exercise is neuroprotective and has many other health benefits; not exercising deprives you of these benefits."
"Is there anything good about smoking? Possibly, we know that smoking protects you from getting Parkinson's disease and there is some evidence that it is the nicotine in tobacco that may be neuroprotective. Therefore, it will be interesting to see how the eCigarette revolution plays out and whether or not smokers of eCigarettes do better than smokers of regular cigarettes and non-smokers. Interestingly, there is weak evidence from Sweden that snuff usage protects you against MS; snuff is not smoked and the active ingredients from the tobacco are absorbed via the mucus membranes of the mouth. All this is very interesting. I can envisage a future trial of add-on nicotine replacement therapy as a possible neuroprotective therapy in MS. What do you think?"
"If you are a smoker you should seriously think about giving-up or using a nicotine replacement therapy."
Durhan et al. Assessment of the effect of cigarette smoking on regional brain volumes and lesion load in patients with clinically isolated syndrome. Int J Neurosci. 2015 Sep 3:1-7.
PURPOSE: Smoking has been associated with an increased risk of developing multiple sclerosis, disease progression and clinical disability. We detected the effects of smoking on regional brain volumes and lesion load in patients with clinically isolated syndrome using quantitative magnetic resonance imaging.
MATERIALS AND METHODS: Smoker patients (n = 16), smoker healthy controls (n = 13), non-smoker patients (n = 17) and non-smoker healthy controls (n = 14) underwent magnetic resonance imaging and neocortical volumes were measured. Lesion load was calculated in terms of number and volume of white matter hyperintensities.
RESULTS: Smoking was associated with increased gray matter volumes in several regions of the brain. A tendency towards greater lesion load in smoker patients was found. Smoking duration was significantly negatively correlated with intracranial volume and left hemisphere cortical gray matter volume. There was no relationship between regional brain volumes and clinical disability scores, lesion load duration of the disease and degree of smoking exposure.
CONCLUSIONS: Clinically isolated syndrome related regional brain atrophy might vary in extent and severity with smoking. Despite increased lesion load, less cortical and deep gray matter damage with a possible neuroprotective effect occurs in smoking.