Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
Nat Rev Neurol. 2012 Nov 5;8(11):602-12. doi: 10.1038/nrneurol.2012.198. Epub 2012 Oct 9.
Although strong genetic determinants of multiple sclerosis (MS) exist, the findings of migration studies support a role for environmental factors in this disease. Through rigorous epidemiological investigation, Epstein-Barr virus infection, vitamin D nutrition and cigarette smoking have been identified as likely causal factors in MS. In this Review, the strength of this evidence is discussed, as well as the potential biological mechanisms underlying the associations between MS and environmental, lifestyle and dietary factors. Both vitamin D nutrition and cigarette smoking are modifiable; as such, increasing vitamin D levels and smoking avoidance have the potential to substantially reduce MS risk and influence disease progression. Improving our understanding of the environmental factors involved in MS will lead to new and more-effective approaches to prevent this disease.
尽管多发性硬化症（MS）存在强烈的遗传决定因素，但迁移研究的结果支持环境因素在这种疾病中的作用。通过严格的流行病学调查，已确定 Epstein-Barr 病毒感染、维生素 D 营养和吸烟是 MS 的可能因果因素。在这篇综述中，讨论了这一证据的强度，以及 MS 与环境、生活方式和饮食因素之间关联的潜在生物学机制。维生素 D 营养和吸烟都是可以改变的；因此，提高维生素 D 水平和避免吸烟有可能显著降低 MS 的风险并影响疾病进展。提高我们对 MS 中涉及的环境因素的理解将导致预防这种疾病的新的、更有效的方法。
