Vol 54, No 3 (2020)
Review article
Published online: 2020-04-14
Submitted: 2020-02-04
Accepted: 2020-03-25
Get Citation

Smoking as a risk factor of onset and relapse of Multiple Sclerosis — a review

Patryk Jasielski, Faustyna Piędel, Agata Rocka, Véronique Petit, Konrad Rejdak
DOI: 10.5603/PJNNS.a2020.0032
·
Pubmed: 32285433
·
Neurol Neurochir Pol 2020;54(3):243-251.

paid access

Vol 54, No 3 (2020)
Review article
Published online: 2020-04-14
Submitted: 2020-02-04
Accepted: 2020-03-25

Abstract

Introduction and objective. Multiple Sclerosis (MS) is a chronic demyelinating disease caused by damage to myelin in the brain and spinal cord. The cause of the disease is unclear, but it is probably correlated with dysregulation of the immunological system, as well as non-modifiable and modifiable risk factors. Unfortunately, there is no cure for MS. However, the course of the condition has been shown to be modifiable by treatment and various environmental factors. Cigarette smoking is one of the most common addictions around the world, and may be a key modifiable risk factor in MS. Here, we review data available on Pubmed and Scopus from the last 10 years. The following consecutive key words were used in our search: “multiple sclerosis”, “smoking”, “cigarette”, “impact”, “progression”, and “tobacco”. This search yielded 248 initial articles, 43 of which were included in our review.

Current state of knowledge. In our review, we have examined the impact of smoking on the immunology, course, treatment, relapse, recurrence, quality of life, and changes visualised on MRI among patients with MS in general. We have also explored these patterns in MS subtypes. In general, smoking is reported to have negative effects on MS, including a decrease in quality of life, as well as cognitive and mental state, and an increase in disability, as well as in the frequency of relapses and recurrences.

Clinical implications. Smoking has a widespread negative impact on patients with MS. Thus, it is important to educate patients and to help them to give up smoking to improve their health and quality of life.

Future directions. Further research about the impact of smoking and nicotine on MS and other neurodegenerative diseases is needed; in particular, research on e-cigarettes.

Abstract

Introduction and objective. Multiple Sclerosis (MS) is a chronic demyelinating disease caused by damage to myelin in the brain and spinal cord. The cause of the disease is unclear, but it is probably correlated with dysregulation of the immunological system, as well as non-modifiable and modifiable risk factors. Unfortunately, there is no cure for MS. However, the course of the condition has been shown to be modifiable by treatment and various environmental factors. Cigarette smoking is one of the most common addictions around the world, and may be a key modifiable risk factor in MS. Here, we review data available on Pubmed and Scopus from the last 10 years. The following consecutive key words were used in our search: “multiple sclerosis”, “smoking”, “cigarette”, “impact”, “progression”, and “tobacco”. This search yielded 248 initial articles, 43 of which were included in our review.

Current state of knowledge. In our review, we have examined the impact of smoking on the immunology, course, treatment, relapse, recurrence, quality of life, and changes visualised on MRI among patients with MS in general. We have also explored these patterns in MS subtypes. In general, smoking is reported to have negative effects on MS, including a decrease in quality of life, as well as cognitive and mental state, and an increase in disability, as well as in the frequency of relapses and recurrences.

Clinical implications. Smoking has a widespread negative impact on patients with MS. Thus, it is important to educate patients and to help them to give up smoking to improve their health and quality of life.

Future directions. Further research about the impact of smoking and nicotine on MS and other neurodegenerative diseases is needed; in particular, research on e-cigarettes.

Get Citation

Keywords

multiple sclerosis, smoking, cigarettes, tobacco, impact, progression

About this article
Title

Smoking as a risk factor of onset and relapse of Multiple Sclerosis — a review

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 54, No 3 (2020)

Pages

243-251

Published online

2020-04-14

DOI

10.5603/PJNNS.a2020.0032

Pubmed

32285433

Bibliographic record

Neurol Neurochir Pol 2020;54(3):243-251.

Keywords

multiple sclerosis
smoking
cigarettes
tobacco
impact
progression

Authors

Patryk Jasielski
Faustyna Piędel
Agata Rocka
Véronique Petit
Konrad Rejdak

References (48)
  1. Wallin M, Culpepper W, Nichols E, et al. Global, regional, and national burden of multiple sclerosis 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology. 2019; 18(3): 269–285.
  2. McDonald W, Compston A, Edan G, et al. Recommended diagnostic criteria for multiple sclerosis: Guidelines from the international panel on the diagnosis of multiple sclerosis. Annals of Neurology. 2001; 50(1): 121–127.
  3. Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018; 17(2): 162–173.
  4. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983; 33(11): 1444–1452.
  5. Mandia D, Ferraro OE, Nosari G, et al. Environmental factors and multiple sclerosis severity: a descriptive study. Int J Environ Res Public Health. 2014; 11(6): 6417–6432.
  6. Ghasemi N, Razavi S, Nikzad E. Multiple Sclerosis: Pathogenesis, Symptoms, Diagnoses and Cell-Based Therapy. Cell J. 2017; 19(1): 1–10.
  7. Gao Z, Nissen JC, Ji K, et al. The experimental autoimmune encephalomyelitis disease course is modulated by nicotine and other cigarette smoke components. PLoS One. 2014; 9(9): e107979.
  8. Enzmann G, Adelfio R, Godel A, et al. The Genetic Background of Mice Influences the Effects of Cigarette Smoke on Onset and Severity of Experimental Autoimmune Encephalomyelitis. Int J Mol Sci. 2019; 20(6).
  9. Paknejad B, Shirkhanloo H, Aliomrani M. Is There Any Relevance Between Serum Heavy Metal Concentration and BBB Leakage in Multiple Sclerosis Patients? Biol Trace Elem Res. 2019; 190(2): 289–294.
  10. Socha K, Kochanowicz J, Karpińska E, et al. Dietary habits and selenium, glutathione peroxidase and total antioxidant status in the serum of patients with relapsing-remitting multiple sclerosis. Nutr J. 2014; 13: 62.
  11. Tao C, Simpson S, Taylor BV, et al. AusLong/Ausimmune Investigators Group. Onset Symptoms, Tobacco Smoking, and Progressive-Onset Phenotype Are Associated With a Delayed Onset of Multiple Sclerosis, and Marijuana Use With an Earlier Onset. Front Neurol. 2018; 9: 418.
  12. Ammitzbøll C, Börnsen L, Petersen ER, et al. Perfluorinated substances, risk factors for multiple sclerosis and cellular immune activation. J Neuroimmunol. 2019; 330: 90–95.
  13. Ammitzbøll C, Börnsen L, Romme Christensen J, et al. Smoking reduces circulating CD26CD161 MAIT cells in healthy individuals and patients with multiple sclerosis. J Leukoc Biol. 2017; 101(5): 1211–1220.
  14. Ammitzbøll C, von Essen MR, Börnsen L, et al. GPR15 T cells are Th17 like, increased in smokers and associated with multiple sclerosis. J Autoimmun. 2019; 97: 114–121.
  15. Lublin FD, Reingold SC. Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology. 1996; 46(4): 907–911.
  16. Lublin FD, Reingold SC, Cohen JA, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014; 83(3): 278–286.
  17. van der Vuurst de Vries RM, Mescheriakova JY, Runia TF, et al. Smoking at time of CIS increases the risk of clinically definite multiple sclerosis. J Neurol. 2018; 265(5): 1010–1015.
  18. O'Gorman CM, Broadley SA. Smoking increases the risk of progression in multiple sclerosis: A cohort study in Queensland, Australia. J Neurol Sci. 2016; 370: 219–223.
  19. Arikanoglu A, Shugaiv E, Tüzün E, et al. Impact of cigarette smoking on conversion from clinically isolated syndrome to clinically definite multiple sclerosis. Int J Neurosci. 2013; 123(7): 476–479.
  20. Roudbari SA, Ansar MM, Yousefzad A. Smoking as a risk factor for development of Secondary Progressive Multiple Sclerosis: A study in IRAN, Guilan. J Neurol Sci. 2013; 330(1-2): 52–55.
  21. Kvistad S, Myhr KM, Holmøy T, et al. No association of tobacco use and disease activity in multiple sclerosis. Neurol Neuroimmunol Neuroinflamm. 2016; 3(4): e260.
  22. Javizian O, Metz LM, Deighton S, et al. Smoking does not influence disability accumulation in primary progressive multiple sclerosis. Eur J Neurol. 2017; 24(4): 624–630.
  23. Briggs FBS, Yu JC, Davis MF, et al. Multiple sclerosis risk factors contribute to onset heterogeneity. Mult Scler Relat Disord. 2019; 28: 11–16.
  24. Weiland TJ, Hadgkiss EJ, Jelinek GA, et al. The association of alcohol consumption and smoking with quality of life, disability and disease activity in an international sample of people with multiple sclerosis. J Neurol Sci. 2014; 336(1-2): 211–219.
  25. Horakova D, Zivadinov R, Weinstock-Guttman B, et al. Environmental factors associated with disease progression after the first demyelinating event: results from the multi-center SET study. PLoS One. 2013; 8(1): e53996.
  26. Kinga M, Balasa R. Effect of serum 25(OH) D level, cigarette smoking and oral contraceptive use on clinical course of relapsing-remitting multiple sclerosis in a group of female patients. Rom J Neurol. 2015; 14(4): 214–218.
  27. Briggs FBS, Thompson NR, Conway DS. Prognostic factors of disability in relapsing remitting multiple sclerosis. Mult Scler Relat Disord. 2019; 30: 9–16.
  28. Marck CH, De Li, Brown CR, et al. Health outcomes and adherence to a healthy lifestyle after a multimodal intervention in people with multiple sclerosis: Three year follow-up. PLoS One. 2018; 13(5): e0197759.
  29. Tanasescu R, Constantinescu CS, Tench CR, et al. Smoking Cessation and the Reduction of Disability Progression in Multiple Sclerosis: A Cohort Study. Nicotine Tob Res. 2018; 20(5): 589–595.
  30. Manouchehrinia A, Tench CR, Maxted J, et al. Tobacco smoking and disability progression in multiple sclerosis: United Kingdom cohort study. Brain. 2013; 136(Pt 7): 2298–2304.
  31. Ivashynka A, Copetti M, Naldi P, et al. The Impact of Lifetime Alcohol and Cigarette Smoking Loads on Multiple Sclerosis Severity. Front Neurol. 2019; 10: 866.
  32. Aktan R, Ozalevli S, Ozakbas S. Effects of cigarette smoking on respiratory problems and functional levels in multiple sclerosis patients. Mult Scler Relat Disord. 2018; 25: 271–275.
  33. Briggs FBs, Gunzler DD, Ontaneda D, et al. Smokers with MS have greater decrements in quality of life and disability than non-smokers. Mult Scler. 2017; 23(13): 1772–1781.
  34. Paz-Ballesteros WC, Monterrubio-Flores EA, de Jesús Flores-Rivera J, et al. Cigarette Smoking, Alcohol Consumption and Overweight in Multiple Sclerosis: Disability Progression. Arch Med Res. 2017; 48(1): 113–120.
  35. D'hooghe MB, Haentjens P, Nagels G, et al. Alcohol, coffee, fish, smoking and disease progression in multiple sclerosis. Eur J Neurol. 2012; 19(4): 616–624.
  36. Jelinek PL, Simpson S, Brown CR, et al. Self-reported cognitive function in a large international cohort of people with multiple sclerosis: associations with lifestyle and other factors. Eur J Neurol. 2019; 26(1): 142–154.
  37. Ozcan ME, Ince B, Bingöl A, et al. Association between smoking and cognitive impairment in multiple sclerosis. Neuropsychiatr Dis Treat. 2014; 10: 1715–1719.
  38. Jain V, Arunkumar A, Kingdon C, et al. Prevalence of and risk factors for severe cognitive and sleep symptoms in ME/CFS and MS. BMC Neurol. 2017; 17(1): 117.
  39. Taylor KL, Simpson S, Jelinek GA, et al. Longitudinal Associations of Modifiable Lifestyle Factors With Positive Depression-Screen Over 2.5-Years in an International Cohort of People Living With Multiple Sclerosis. Front Psychiatry. 2018; 9: 526.
  40. Taylor KL, Hadgkiss EJ, Jelinek GA, et al. Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis. BMC Psychiatry. 2014; 14: 327.
  41. Jelinek GA, De Livera AM, Marck CH, et al. Lifestyle, medication and socio-demographic determinants of mental and physical health-related quality of life in people with multiple sclerosis. BMC Neurol. 2016; 16(1): 235.
  42. Carnero Contentti E, López PA, Nadur D, et al. Impact, Frequency, and Severity of Restless Legs Syndrome in Patients with Multiple Sclerosis in Argentina. Int J MS Care. 2019; 21(4): 157–165.
  43. Durhan G, Diker S, Has AC, et al. Influence of cigarette smoking on white matter in patients with clinically isolated syndrome as detected by diffusion tensor imaging. Diagn Interv Radiol. 2016; 22(3): 291–296.
  44. Graetz C, Gröger A, Luessi F, et al. Association of smoking but not HLA-DRB1*15:01, APOE or body mass index with brain atrophy in early multiple sclerosis. Mult Scler. 2019; 25(5): 661–668.
  45. Durhan G, Diker S, Has AC, 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. 2016; 126(9): 805–811.
  46. Manouchehrinia A, Weston M, Tench CR, et al. Tobacco smoking and excess mortality in multiple sclerosis: a cohort study. J Neurol Neurosurg Psychiatry. 2014; 85(10): 1091–1095.
  47. Hedström AK, Olsson T, Alfredsson L. Smoking is a major preventable risk factor for multiple sclerosis. Mult Scler. 2016; 22(8): 1021–1026.
  48. Mandia D, Ferraro OE, Nosari G, et al. Environmental factors and multiple sclerosis severity: a descriptive study. Int J Environ Res Public Health. 2014; 11(6): 6417–6432.

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