Association Between Cigarette Smoking and Multiple Sclerosis: A Review.,JAMA Neurology

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Association Between Cigarette Smoking and Multiple Sclerosis: A Review.
JAMA Neurology ( IF 20.4 ) Pub Date : 2019-12-16 , DOI: 10.1001/jamaneurol.2019.4271
Mattia Rosso ₁ , Tanuja Chitnis _{1,

2}

Affiliation

Importance Cigarette smoking is a common environmental exposure and addiction, which has severe health consequences. Smoking is a risk factor for multiple sclerosis (MS); also, smoking has been associated with disease activity and overall prognosis for patients with MS. Observations Cigarette smoking is an irritative agent on the lungs, in which a proinflammatory cascade starts that culminates in autoimmunity. Inflammation may increase the risk of MS in some individuals, in a process driven by antigen cross-reactivity between lung antigens and myelin antigens. Genetics plays a central role in the individual predisposition to mounting an autoimmune reaction. Also, free radicals, cyanates, and carbon monoxide in cigarette smoke may be directly toxic to neurons. Patients with MS who smoke have higher rates of disease activity, faster rates of brain atrophy, and a greater disability burden. Some of the outcomes of smoking were found to be reversible, which makes counseling key. Conclusions and Relevance The pathways involved in cigarette smoking should be further analyzed to understand the mechanisms whereby smoking worsens MS prognosis. The proinflammatory and neurotoxic outcomes of cigarette smoking may be shared by other environmental exposures, such as pollution and organic solvents. From a global perspective, efforts should be made to diminish the prevalence of cigarette smoking in patients with MS.

中文翻译：

吸烟与多发性硬化之间的关联：综述。

重要性吸烟是一种常见的环境暴露和成瘾，会对健康造成严重影响。吸烟是多发性硬化症（MS）的危险因素；同样，吸烟已与MS患者的疾病活动和总体预后相关。观察结果吸烟是对肺部的刺激性物质，其中的促炎性级联反应开始，最终导致自身免疫。在由肺抗原和髓磷脂抗原之间的抗原交叉反应驱动的过程中，炎症可能会增加某些个体患MS的风险。遗传学在引发自身免疫反应的个体易感性中起着核心作用。而且，香烟烟雾中的自由基，氰酸盐和一氧化碳可能对神经元直接有毒。吸烟的MS患者的疾病活动率更高，更快的脑萎缩率和更大的残疾负担。发现吸烟的某些结果是可逆的，这使咨询成为关键。结论和相关性应该进一步分析吸烟中涉及的途径，以了解吸烟使MS预后恶化的机制。吸烟的促炎和神经毒性结果可能与其他环境暴露（例如污染和有机溶剂）共享。从全球的角度来看，应努力减少MS患者吸烟的患病率。结论和相关性应该进一步分析吸烟中涉及的途径，以了解吸烟使MS预后恶化的机制。吸烟的促炎性和神经毒性结果可能与其他环境暴露（例如污染和有机溶剂）共享。从全球的角度来看，应努力减少MS患者吸烟的患病率。结论和相关性应该进一步分析吸烟中涉及的途径，以了解吸烟使MS预后恶化的机制。吸烟的促炎性和神经毒性结果可能与其他环境暴露（例如污染和有机溶剂）共享。从全球的角度来看，应努力减少MS患者吸烟的患病率。

更新日期：2020-02-10

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