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Sun exposure across the life course significantly modulates early multiple sclerosis clinical course

Simpson, Steve, Van Der Mei, Ingrid, Lucas, Robyn M, Ponsonby, Anne-Louise, Broadley, Simon, Blizzard, Leigh, Dear, Keith, Dwyer, Terry, Taylor, Bruce V, Kilpatrick, Trevor, Williams, David, Lechner-Scott, Jeanette, Shaw, Cameron, Chapman, Caron, Coulthard, Alan, Pender, Michael P, Valery, Patricia and Taylor, Bruce 2018, Sun exposure across the life course significantly modulates early multiple sclerosis clinical course, Frontiers in neurology, vol. 9, pp. 1-17, doi: 10.3389/fneur.2018.00016.

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Title Sun exposure across the life course significantly modulates early multiple sclerosis clinical course
Author(s) Simpson, Steve
Van Der Mei, Ingrid
Lucas, Robyn M
Ponsonby, Anne-Louise
Broadley, Simon
Blizzard, Leigh
Dear, Keith
Dwyer, Terry
Taylor, Bruce V
Kilpatrick, Trevor
Williams, David
Lechner-Scott, Jeanette
Shaw, Cameron
Chapman, Caron
Coulthard, Alan
Pender, Michael P
Valery, Patricia
Taylor, Bruce
Journal name Frontiers in neurology
Volume number 9
Article ID 16
Start page 1
End page 17
Total pages 17
Publisher Frontiers Media
Place of publication Lausanne, Switzerland
Publication date 2018-02-01
ISSN 1664-2295
Keyword(s) multiple sclerosis
vitamin D
sun exposure
ultraviolet radiation
relapse
behaviour change
first demyelinating event
CIS
Summary Background: Low vitamin D and/or sun exposure have been associated with increased risk of multiple sclerosis (MS) onset. However, comparatively, few studies have prospectively examined associations between these factors and clinical course. Objectives: To evaluate the association of sun exposure parameters and vitamin D levels with conversion to MS and relapse risk in a prospectively monitored cohort of 145 participants followed after a first demyelinating event up to 5-year review (AusLong Study).

Methods: Sun exposure prior to and after onset measured by annual questionnaire; ultraviolet radiation (UVR) "load" estimated by location of residence over the life course and ambient UVR levels. Serum 25-hydroxyvitamin D [25(OH)D] concentrations measured at baseline, 2/3-year, and 5-year review. MS conversion and relapse assessed by neurologist assessment and medical record review.

Results: Over two-thirds (69%) of those followed to 5-year review (100/145) converted to MS, with a total of 252 relapses. Higher pre-MS onset sun exposure was associated with reduced risk of MS conversion, with internal consistency between measures and dose-response relationships. Analogous associations were also seen with risk of relapse, albeit less strong. No consistent associations were observed between postonset sun exposure and clinical course, however. Notably, those who increased their sun exposure during follow-up had significantly reduced hazards of MS conversion and relapse. Serum 25(OH)D levels and vitamin D supplementation were not associated with conversion to MS or relapse hazard.

Conclusion: We found that preonset sun exposure was protective against subsequent conversion to MS and relapses. While consistent associations between postonset sun exposure or serum 25(OH)D level and clinical course were not evident, possibly masked by behavior change, those participants who markedly increased their sun exposure demonstrated a reduced MS conversion and relapse hazard, suggesting beneficial effects of sun exposure on clinical course.
Language eng
DOI 10.3389/fneur.2018.00016
Field of Research 1109 Neurosciences
1103 Clinical Sciences
1701 Psychology
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, Simpson, van der Mei, Lucas, Ponsonby, Broadley, Blizzard, Ausimmune/AusLong Investigators Group and Taylor
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30110472

Document type: Journal Article
Collections: School of Medicine
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.