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- W2048397314 abstract "Abstract The discovery of a specific biomarker for neuromyelitis optica ( NMO ), NMO ‐immunoglobulin G ( I g G )/anti‐aquaporin‐4 ( AQP 4) antibody, requires us to take it into account when interpreting epidemiological findings on multiple sclerosis ( MS ). Recent genetic studies showed that HLA ‐ DRB 1*0405 is the most common susceptibility allele for non‐ NMO MS in J apanese, and that DRB 1*0405 carriers comprise >40% of all Japanese MS patients. Thus, idiopathic central nervous system demyelinating disease in J apanese can be subclassified into DRB 1*0405 ‐positive and ‐negative MS , and anti‐ AQP 4 antibody‐positive and ‐negative NMO . HLA ‐ DRB 1*0405 ‐positive MS patients show younger age at onset, fewer brain lesions and a slower progression. The recent increase in the numbers of MS patients in this subgroup could explain the decrease in age at onset, as shown by the fourth nationwide survey in Japanese MS patients. Among HLA ‐ DRB 1*0405 ‐negative MS patients, DRB 1*1501 is a risk factor for MS , and DRB 1*1501 carriers have high frequencies of brain lesions fulfilling the Barkhof criteria and cerebrospinal fluid I g G abnormalities. HLA ‐ DRB 1*0405 ‐negative MS patients have higher frequencies of Epstein–Barr virus infection, but a lower frequency of H elicobacter pylori infection, which reflects improved sanitation in childhood. Anti‐ AQP 4 antibody‐positive NMO is associated with H . pylori and C hlamydia pneumoniae infections. The effects of improved sanitation on this subgroup might explain the decrease in incidence of opticospinal MS with longitudinally extensive spinal cord lesions, regarded as the same disease as NMO , as suggested by the fourth nationwide survey. Therefore, changes in environmental factors could have differentially influenced susceptibility to each disease subtype in J apanese." @default.
- W2048397314 created "2016-06-24" @default.
- W2048397314 creator A5029405594 @default.
- W2048397314 date "2013-08-29" @default.
- W2048397314 modified "2023-10-15" @default.
- W2048397314 title "Genetic and environmental factors underlying the rapid changes in epidemiological and clinical features of multiple sclerosis and neuromyelitis optica in Japanese" @default.
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