Department of Immunology and Transfusion Medicine (S.K.), Norwegian Multiple Sclerosis Competence Centre, Department of Neurology (S.K., S.W., Ø.T.), and Norwegian Multiple Sclerosis Registry and Biobank, Department of Neurology (K.-M.M., S.W., Ø.T.), Haukeland University Hospital, Bergen; KG Jebsen MS Research Centre (S.K., K.-M.M., Ø.T.), Department of Clinical Medicine, University of Bergen; Department of Neurology (T.H.), and HØKH, Research Centre (J.Š.B.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., J.Š.B.), University of Oslo; Department of Neurology (K.I.L.-A.), Innlandet Hospital Trust, Lillehammer; Multiple Sclerosis Centre Hakadal (A.G.B.); Clinic of Laboratory Medicine (K.S.B.) and Department of Neurology (H.H.), St. Olavs Hospital, Trondheim University Hospital; Department of Laboratory Medicine (K.S.B.), Children's and Women's Health, Norwegian University of Science and Technology, Trondheim; Curato Oslo (F.L.); Department of Neurology (R.M.), Molde Hospital; Unit for Applied Clinical Research (R.M.), Norwegian University of Science and Technology, Trondheim; Unilabs Drammen (T.P.), Drammen; and Department of Neuroradiology (S.J.B.), Oslo University Hospital Rikshospitalet, Norway.
Neurol Neuroimmunol Neuroinflamm. 2016 Jul 14;3(4):e260. doi: 10.1212/NXI.0000000000000260. eCollection 2016 Aug.
To study whether tobacco use is associated with MRI and clinical disease activity in patients with multiple sclerosis (MS).
Prospective cohort study of 87 patients with relapsing-remitting MS originally included in a randomized placebo-controlled trial of omega-3 fatty acids in MS (the OFAMS Study). Serum levels of cotinine (biomarker of tobacco use) were analyzed at baseline and every 6 months for 2 years. MRI activity was assessed at baseline and monthly for 9 months and after 12 and 24 months.
Fifty-three patients (61%) had serum cotinine levels ≥85 nmol/L on ≥60% of the measurements and were considered tobacco users and 34 (39%) had cotinine levels <85 nmol/L, consistent with non-tobacco use. There was no association between tobacco use and the occurrence of new gadolinium-enhancing T1 lesions, new or enlarging T2 lesions, or their aggregate (combined unique activity). Furthermore, there was no association between cotinine levels and MRI activity for the tobacco users, and tobacco users did not have more relapses or Expanded Disability Status Scale progression.
Our results indicate that tobacco use does not directly influence MRI activity or relapse rate in MS. This may implicate that the reported association between smoking and MS disease progression could be mediated through other mechanisms.
研究吸烟是否与多发性硬化症（MS）患者的 MRI 和临床疾病活动有关。
对 87 例复发性缓解型多发性硬化症患者进行前瞻性队列研究，这些患者最初被纳入 MS 中ω-3 脂肪酸的随机安慰剂对照试验（OFAMS 研究）。在基线和每 6 个月测量 2 年期间，分析血清可替宁（吸烟生物标志物）水平。在基线和每月评估 MRI 活动，持续 9 个月，然后在 12 个月和 24 个月时进行评估。
53 名患者（61%）在≥60%的测量中血清可替宁水平≥85nmol/L，被认为是吸烟者，34 名患者（39%）可替宁水平<85nmol/L，与非吸烟者一致。吸烟与新钆增强 T1 病变、新病变或扩大 T2 病变或其总和（联合独特活动）的发生之间没有关联。此外，吸烟组的可替宁水平与 MRI 活动之间没有关联，吸烟组的复发或扩展残疾状况量表进展也没有增加。
我们的结果表明，吸烟不会直接影响 MS 的 MRI 活动或复发率。这可能意味着吸烟与 MS 疾病进展之间的报告关联可能通过其他机制介导。
