Environmental Influences on Risk and Disease Course in Pediatric Multiple Sclerosis

Pediatric multiple sclerosis (MS) accounts for 3%-10% of all patients diagnosed with MS. Complex interplay between environmental factors impacts the risk for MS and may also affect disease course. Many of these environmental factors are shared with adult-onset MS. However, children with MS are in closer temporal proximity to the biological onset of MS and have less confounding environmental exposures than their adult counterparts. Environmental factors that contribute to MS risk include: geographical latitude, viral exposures, obesity, vitamin deficiencies, smoking, air pollution, perinatal factors, gut microbiome, and diet. More recently, research efforts have shifted to studying the impact of these risk determinants on the clinical course of MS. In this article we will examine relevant environmental risk determinants of pediatric MS and review the current knowledge on how these factors may contribute to pediatric MS disease evolution. Semin Pediatr Neurol 46:101049 & COPY; 2023 Elsevier Inc. All rights reserved.

Automated summary

Pediatric multiple sclerosis (MS) accounts for a small percentage of all MS cases, but the environmental factors that contribute to the risk are similar to adult-onset MS. Children with MS are in closer proximity to the disease onset and have fewer confounding environmental factors. This article examines the environmental risk determinants of pediatric MS and reviews how these factors may impact the disease's evolution.