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Mult Scler. 2017 Jan 6:1352458516686847. doi: 10.1177/1352458516686847. [Epub ahead of print]

Environmental modifiable risk factors for multiple sclerosis: Report from the 2016 ECTRIMS focused workshop.

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Department of NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy.
Departments of Neurology and Biomedicine, University Hospital Basel, Basel, Switzerland.
Technische Universitat Munchen, Munchen, Germany.
Faculte de Medecine Purpan, Universite Toulouse III - Paul Sabatier, Toulouse, France.
Unitat de Neuroimmunologia Clínica, Barcelona, Spain.
Det Sundhedsvidenskabelige Fakultet, Kobenhavns Universitet, Kobenhavn, Denmark.
Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, UK.


Multiple sclerosis (MS) is an inflammatory and neurodegenerative demyelinating disease of the central nervous system (CNS), most likely autoimmune in origin, usually beginning in early adulthood. The aetiology of the disease is not well understood; it is viewed currently as a multifactorial disease which results from complex interactions between genetic predisposition and environmental factors, of which a few are potentially modifiable. Improving our understanding of these factors can lead to new and more effective approaches to patient counselling and, possibly, prevention and management of the disease. The 2016 focused workshop of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) addressed the topic of environmental, modifiable risk factors for MS, gathering experts from around the world, to collate experimental and clinical research into environmental factors that have been associated with the disease onset and, in a few cases, disease activity and progression. A number of factors, including infections, vitamin D deficiency, diet and lifestyle factors, stress and comorbidities, were discussed. The meeting provided a forum to analyse available evidence, to identify inconsistencies and gaps in current knowledge and to suggest avenues for future research.


Multiple sclerosis; comorbidities; environmental risk factors; infections; lifestyle; vitamin D

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