Evidence map›Paper›PMID 31392849›Full record

ReviewAnnals of clinical and translational neurology2019

Environmental and genetic risk factors for MS: an integrated review.

Emmanuelle Waubant, Robyn Lucas, Ellen Mowry, Jennifer Graves, Tomas Olsson, Lars Alfredsson, Annette Langer-Gould

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Annals of clinical and translational neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 171 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
171citing papers in PubMed, 7 pooled it
–field-weighted citation impact
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

171 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Pooled it
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  8. Trial
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  16. Towards primary prevention of multiple sclerosis.Nature reviews. Neurology · 2026
    Review
  17. Article
  18. Review
  19. Toward a global research agenda for preventing multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2026
    Article
  20. Article

111 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Emmanuelle WaubantDepartment of Neurology, UC San Francisco, San Francisco, California.ORCID 0000-0001-5188-0157
Robyn LucasNational Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia.
Ellen MowryDepartment of Neurology and Epidemiology, Johns Hopkins University, Baltimore, Maryland.
Jennifer GravesDepartment of Neurosciences, UC San Diego, San Diego, California.
Tomas OlssonDepartment of Neurology, Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden.
Lars AlfredssonDepartment of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Annette Langer-GouldClinical & Translational Neuroscience, Kaiser Permanente/Southern California Permanente Medical Group, Los Angeles, California.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Recent findings have provided a molecular basis for the combined contributions of multifaceted risk factors for the onset of multiple sclerosis (MS). MS appears to start as a chronic dysregulation of immune homeostasis resulting from complex interactions between genetic predispositions, infectious exposures, and factors that lead to pro-inflammatory states, including smoking, obesity, and low sun exposure. This is supported by the discovery of gene-environment (GxE) interactions and epigenetic alterations triggered by environmental exposures in individuals with particular genetic make-ups. It is notable that several of these pro-inflammatory factors have not emerged as strong prognostic indicators. Biological processes at play during the relapsing phase of the disease may result from initial inflammatory-mediated injury, while risk factors for the later phase of MS, which is weighted toward neurodegeneration, are not yet well defined. This integrated review of current evidence guides recommendations for clinical practice and highlights research gaps.

Indexed as

Gene-Environment InteractionGenetic Predisposition to DiseaseEnvironmental ExposureHumansMultiple SclerosisRisk FactorsSmoking

Identifiers

PMID31392849
PMCPMC6764632

What OpenQuestion holds

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Registered trials

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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.