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<title>UTas ePrints - Exposure to infant siblings during early life and risk of multiple sclerosis</title>
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<meta content="Ponsonby, A-L." name="eprints.creators_name" />
<meta content="van der Mei, I.A.F." name="eprints.creators_name" />
<meta content="Dwyer, T." name="eprints.creators_name" />
<meta content="Blizzard, Leigh" name="eprints.creators_name" />
<meta content="Taylor, B.V." name="eprints.creators_name" />
<meta content="Kemp, A." name="eprints.creators_name" />
<meta content="Simmons, R." name="eprints.creators_name" />
<meta content="Kilpatrick, T." name="eprints.creators_name" />
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<meta content="Ingrid.vanderMei@utas.edu.au" name="eprints.creators_id" />
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<meta content="2007-04-02" name="eprints.datestamp" />
<meta content="2008-01-08 15:30:00" name="eprints.lastmod" />
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<meta content="Exposure to infant siblings during early life and risk of multiple sclerosis" name="eprints.title" />
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<meta content="infant sibling, early life, Epstein-Barr virus, multiple sclerosis" name="eprints.keywords" />
<meta content="Context The 'hygiene hypothesis' has implicated sibship as a marker of infection load during early life and suggests exposure or re-exposure to infections can influence the developing immune system. Viral infection has been implicated in the pathogenesis of multiple sclerosis (MS).
Objectives To evaluate whether exposure to infant siblings in early life is associated with the risk of MS . To explore the possible mechanism for any apparent protective effect, including altered Epstein-Barr virus (EBV) infection patterns.
Design, setting and patients Population-based case-control study in Tasmania, Australia from 1999 to 2001 based on 136 cases of MRI-confirmed MS and 272 community controls, matched on sex and year of birth.
Main Outcome Measure Risk of MS and serum EBV IgG response by duration of contact with younger siblings aged less than 2 years in the first 6 years of life.
Results Increasing duration of contact with a younger sibling aged less than 2 years in the first 6 years of life was associated with reduced MS risk (Adjusted Odds Ratios: Less than 1 infant-years, 1:00 [reference]; 1 to 3 infant-years, 0.59 [ 95%CI, 0.34-1.02]; 3 to 5 infant-years, 0.47 [ 95%CI, 0.23, 1.02]; 5 or more infant-years, 0.23 [ 95%CI, 0.07, 0.72]; test for trend p = 0.002). A history of exposure to infant siblings was associated with a reduced IgG response to EBV among controls. Controls with at least one infant-year contact had a reduced risk of infectious mononucleosis (AOR 0.44 [ 95% CI, 0.21,0.92]) and a reduced risk of very high composite EBV IgG titres (AOR 0.33 [ 95% CI, 0.11,0.98 ]) compared to other controls. The inverse association between higher infant contact and MS was independent of EBV IgG titre.
Conclusion Higher infant sibling exposure in the first six years of life was associated with a reduced risk of MS, possibly by altering childhood infection patterns and related immune responses.
" name="eprints.abstract" />
<meta content="2005-01-26" name="eprints.date" />
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<meta content="JAMA" name="eprints.publication" />
<meta content="293" name="eprints.volume" />
<meta content="4" name="eprints.number" />
<meta content="463-469" name="eprints.pagerange" />
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<meta content="print 0098-7484; online 1538-3598" name="eprints.issn" />
<meta content="1.Bach JF. The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med 2002; 347:911-20.
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<meta content="Ponsonby, A-L. and van der Mei, I.A.F. and Dwyer, T. and Blizzard, Leigh and Taylor, B.V. and Kemp, A. and Simmons, R. and Kilpatrick, T. (2005) Exposure to infant siblings during early life and risk of multiple sclerosis. JAMA, 293 (4). pp. 463-469. ISSN print 0098-7484; online 1538-3598" name="eprints.citation" />
<meta content="http://eprints.utas.edu.au/891/1/Ponsonby_JAMA_05.pdf" name="eprints.document_url" />
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<meta content="Exposure to infant siblings during early life and risk of multiple sclerosis" name="DC.title" />
<meta content="Ponsonby, A-L." name="DC.creator" />
<meta content="van der Mei, I.A.F." name="DC.creator" />
<meta content="Dwyer, T." name="DC.creator" />
<meta content="Blizzard, Leigh" name="DC.creator" />
<meta content="Taylor, B.V." name="DC.creator" />
<meta content="Kemp, A." name="DC.creator" />
<meta content="Simmons, R." name="DC.creator" />
<meta content="Kilpatrick, T." name="DC.creator" />
<meta content="321202 Epidemiology" name="DC.subject" />
<meta content="Context The 'hygiene hypothesis' has implicated sibship as a marker of infection load during early life and suggests exposure or re-exposure to infections can influence the developing immune system. Viral infection has been implicated in the pathogenesis of multiple sclerosis (MS).
Objectives To evaluate whether exposure to infant siblings in early life is associated with the risk of MS . To explore the possible mechanism for any apparent protective effect, including altered Epstein-Barr virus (EBV) infection patterns.
Design, setting and patients Population-based case-control study in Tasmania, Australia from 1999 to 2001 based on 136 cases of MRI-confirmed MS and 272 community controls, matched on sex and year of birth.
Main Outcome Measure Risk of MS and serum EBV IgG response by duration of contact with younger siblings aged less than 2 years in the first 6 years of life.
Results Increasing duration of contact with a younger sibling aged less than 2 years in the first 6 years of life was associated with reduced MS risk (Adjusted Odds Ratios: Less than 1 infant-years, 1:00 [reference]; 1 to 3 infant-years, 0.59 [ 95%CI, 0.34-1.02]; 3 to 5 infant-years, 0.47 [ 95%CI, 0.23, 1.02]; 5 or more infant-years, 0.23 [ 95%CI, 0.07, 0.72]; test for trend p = 0.002). A history of exposure to infant siblings was associated with a reduced IgG response to EBV among controls. Controls with at least one infant-year contact had a reduced risk of infectious mononucleosis (AOR 0.44 [ 95% CI, 0.21,0.92]) and a reduced risk of very high composite EBV IgG titres (AOR 0.33 [ 95% CI, 0.11,0.98 ]) compared to other controls. The inverse association between higher infant contact and MS was independent of EBV IgG titre.
Conclusion Higher infant sibling exposure in the first six years of life was associated with a reduced risk of MS, possibly by altering childhood infection patterns and related immune responses.
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<h1 class="ep_tm_pagetitle">Exposure to infant siblings during early life and risk of multiple sclerosis</h1>
<p style="margin-bottom: 1em" class="not_ep_block"><span class="person_name">Ponsonby, A-L.</span> and <span class="person_name">van der Mei, I.A.F.</span> and <span class="person_name">Dwyer, T.</span> and <span class="person_name">Blizzard, Leigh</span> and <span class="person_name">Taylor, B.V.</span> and <span class="person_name">Kemp, A.</span> and <span class="person_name">Simmons, R.</span> and <span class="person_name">Kilpatrick, T.</span> (2005) <xhtml:em>Exposure to infant siblings during early life and risk of multiple sclerosis.</xhtml:em> JAMA, 293 (4). pp. 463-469. ISSN print 0098-7484; online 1538-3598</p><p style="margin-bottom: 1em" class="not_ep_block"></p><table style="margin-bottom: 1em" class="not_ep_block"><tr><td valign="top" style="text-align:center"><a href="http://eprints.utas.edu.au/891/1/Ponsonby_JAMA_05.pdf"><img alt="[img]" src="http://eprints.utas.edu.au/style/images/fileicons/application_pdf.png" class="ep_doc_icon" border="0" /></a></td><td valign="top"><a href="http://eprints.utas.edu.au/891/1/Ponsonby_JAMA_05.pdf"><span class="ep_document_citation">PDF</span></a> - Full text restricted - Requires a PDF viewer<br />120Kb</td><td><form method="get" accept-charset="utf-8" action="http://eprints.utas.edu.au/cgi/request_doc"><input accept-charset="utf-8" value="897" name="docid" type="hidden" /><div class=""><input value="Request a copy" name="_action_null" class="ep_form_action_button" onclick="return EPJS_button_pushed( '_action_null' )" type="submit" /> </div></form></td></tr></table><div class="not_ep_block"><h2>Abstract</h2><p style="padding-bottom: 16px; text-align: left; margin: 1em auto 0em auto">Context The 'hygiene hypothesis' has implicated sibship as a marker of infection load during early life and suggests exposure or re-exposure to infections can influence the developing immune system. Viral infection has been implicated in the pathogenesis of multiple sclerosis (MS).
Objectives To evaluate whether exposure to infant siblings in early life is associated with the risk of MS . To explore the possible mechanism for any apparent protective effect, including altered Epstein-Barr virus (EBV) infection patterns.
Design, setting and patients Population-based case-control study in Tasmania, Australia from 1999 to 2001 based on 136 cases of MRI-confirmed MS and 272 community controls, matched on sex and year of birth.
Main Outcome Measure Risk of MS and serum EBV IgG response by duration of contact with younger siblings aged less than 2 years in the first 6 years of life.
Results Increasing duration of contact with a younger sibling aged less than 2 years in the first 6 years of life was associated with reduced MS risk (Adjusted Odds Ratios: Less than 1 infant-years, 1:00 [reference]; 1 to 3 infant-years, 0.59 [ 95%CI, 0.34-1.02]; 3 to 5 infant-years, 0.47 [ 95%CI, 0.23, 1.02]; 5 or more infant-years, 0.23 [ 95%CI, 0.07, 0.72]; test for trend p = 0.002). A history of exposure to infant siblings was associated with a reduced IgG response to EBV among controls. Controls with at least one infant-year contact had a reduced risk of infectious mononucleosis (AOR 0.44 [ 95% CI, 0.21,0.92]) and a reduced risk of very high composite EBV IgG titres (AOR 0.33 [ 95% CI, 0.11,0.98 ]) compared to other controls. The inverse association between higher infant contact and MS was independent of EBV IgG titre.
Conclusion Higher infant sibling exposure in the first six years of life was associated with a reduced risk of MS, possibly by altering childhood infection patterns and related immune responses.
</p></div><table style="margin-bottom: 1em" cellpadding="3" class="not_ep_block" border="0"><tr><th valign="top" class="ep_row">Item Type:</th><td valign="top" class="ep_row">Article</td></tr><tr><th valign="top" class="ep_row">Keywords:</th><td valign="top" class="ep_row">infant sibling, early life, Epstein-Barr virus, multiple sclerosis</td></tr><tr><th valign="top" class="ep_row">Subjects:</th><td valign="top" class="ep_row"><a href="http://eprints.utas.edu.au/view/subjects/321202.html">320000 Medical and Health Sciences > 321200 Public Health and Health Services > 321202 Epidemiology</a></td></tr><tr><th valign="top" class="ep_row">ID Code:</th><td valign="top" class="ep_row">891</td></tr><tr><th valign="top" class="ep_row">Deposited By:</th><td valign="top" class="ep_row"><span class="ep_name_citation"><span class="person_name">Dr Ingrid A F van der Mei</span></span></td></tr><tr><th valign="top" class="ep_row">Deposited On:</th><td valign="top" class="ep_row">02 Apr 2007</td></tr><tr><th valign="top" class="ep_row">Last Modified:</th><td valign="top" class="ep_row">09 Jan 2008 02:30</td></tr><tr><th valign="top" class="ep_row">ePrint Statistics:</th><td valign="top" class="ep_row"><a target="ePrintStats" href="/es/index.php?action=show_detail_eprint;id=891;">View statistics for this ePrint</a></td></tr></table><p align="right">Repository Staff Only: <a href="http://eprints.utas.edu.au/cgi/users/home?screen=EPrint::View&eprintid=891">item control page</a></p>
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