Evidence map›Paper›PMID 20375311›Full record

ArticleNeurology2010

Combined effects of smoking, anti-EBNA antibodies, and HLA-DRB1*1501 on multiple sclerosis risk.

K C Simon, I A F van der Mei, K L Munger, A Ponsonby, J Dickinson, T Dwyer, P Sundström, A Ascherio

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 6 pooled it
11.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 6 syntheses or guidelines pooled it, 132 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Multiple sclerosis and infection: history, EBV, and the search for mechanism.Microbiology and molecular biology reviews : MMBR · 2025
    Review
  9. Review
  10. Article
  11. Article
  12. Review
  13. Article
  14. Obesity's role in MS: An intervention target with possible interactions.Neurology(R) neuroimmunology & neuroinflammation · 2021
    Article
  15. Article
  16. Article
  17. Article
  18. Observational
  19. Review
  20. Multiple sclerosis in the Republic of San Marino, Italian peninsula: an incidence and prevalence study from a high-risk area.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2018
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

K C SimonDepartments of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
I A F van der Mei
K L Munger
A Ponsonby
J Dickinson
T Dwyer
P Sundström
A Ascherio
Murdoch Children's Research Institute · AU

Funding

Interdisciplinary Training in Genes and the EnvironmentT32ES016645 · NIEHS · HARVARD SCHOOL OF PUBLIC HEALTH · PI LEE, CHIH-HAO · 2008 to 2018
$4.0M
Molecular Epidemiology of EBV and Multiple SclerosisR01NS047467 · NINDS · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI ASCHERIO, ALBERTO · 2005 to 2008
$2.5M
NIEHS NIH HHS T32 ES016645-01NINDS NIH HHS R01 NS47467
6 · The paper itself

Abstract

objectiveTo examine the interplay between smoking, serum antibody titers to the Epstein-Barr virus nuclear antigens (anti-EBNA), and HLA-DR15 on multiple sclerosis (MS) risk.

methodsIndividual and pooled analyses were conducted among 442 cases and 865 controls from 3 MS case-control studies-a nested case-control study in the Nurses' Health Study/Nurses' Health Study II, the Tasmanian MS Study, and a Swedish MS Study. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% CIs for the association between smoking, anti-EBNA titers, HLA-DR15, and MS risk. Study estimates were pooled using inverse variance weights to determine a combined effect and p value.

resultsAmong MS cases, anti-EBNA titers were significantly higher in ever smokers compared to never smokers. The increased risk of MS associated with high anti-EBNA Ab titers was stronger among ever smokers (OR = 3.9, 95% CI = 2.7-5.7) compared to never smokers (OR = 1.8, 95% CI = 1.4-2.3; p for interaction = 0.001). The increased risk of MS associated with a history of smoking was no longer evident after adjustment for anti-EBNA Ab titers. No modification or confounding by HLA-DR15 was observed. The increased risk of MS associated with ever smoking was only observed among those who had high anti-EBNA titers (OR = 1.7, 95% CI = 1.1-2.6).

conclusionsSmoking appears to enhance the association between high anti-EBNA titer and increased multiple sclerosis (MS) risk. The association between HLA-DR15 and MS risk is independent of smoking. Further work is necessary to elucidate possible biologic mechanisms to explain this finding.

Indexed as

AdultCase-Control StudiesEpstein-Barr Virus Nuclear AntigensFemaleHaplotypesHLA-DR AntigensHLA-DRB1 ChainsHumansMaleMiddle AgedMultiple SclerosisOdds RatioRiskRisk FactorsSmokingEpstein-Barr Virus Nuclear AntigensHLA-DR AntigensHLA-DRB1*15:01 antigenHLA-DRB1 Chains

Identifiers

PMID20375311
PMCPMC2875934
OpenAlexW2164871576

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.