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Effect of endocrine disrupting chemicals on early disease course in Multiple sclerosis (P5-3.004)
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A small pilot study found that female multiple sclerosis patients with higher levels of phthalate metabolites in their urine were more likely to have recently initiated disease, suggesting a possible link between exposure to these endocrine-disrupting chemicals — commonly found in plastics — and MS onset. While the sample size is very small and the findings are preliminary, phthalates are widespread microplastic-associated chemicals that may warrant attention as a neurological risk factor in women.
Objective: Analyze whether endocrine disrupting chemicals (EDCs) correlate with initiation of Multiple sclerosis (MS) in females Background: MS is the most common neuroinflammatory disease with a female predominant ratio of 3:1. Sex hormones are implicated, as most pediatric MS cases occur after puberty, and pregnancy is protective against disease activity. EDCs including phenols, parabens, and phthalates are found ubiquitously in the modern lifestyle. They interfere with natural hormone homeostasis in the body via estrogen receptor signaling. This study focuses on whether exposure to EDCs affect MS initiation. Design/Methods: 30 female patients were recruited from the Brigham MS Center. Enrollment criteria included diagnosis with MS within the past 5 years, and consent to provide a blood and urine sample and completed a questionnaire about potential EDC exposures. Exclusion criteria were intravenous steroids in the past 30 days. Samples were analyzed by NSF International (Ann Arbor, Michigan) by LC-MS for phenols, parabens, and phthalates. Statistical results were obtained using R. Results: We find that females with higher levels of the phthalates mECPP and mEOHP had higher annualized relapse rates (ARR) from onset of disease (Spearman coefficient, R=0.55, p=0.0014; R=0.65, p=7.8e-05). mECPP and mEOHP levels also correlated with increased number of T2 lesions on MRI (R=0.51, p=0.0033; R=0.57, p=8e-04). mECPP levels were inversely correlated with fish intake (R=−0.38, p=0.02. mEOHP was non-significantly inversely correlated with fish intake (R=−0.30, p=0.06). None of the EDCs analyzed were correlated with use of dishwashers, personal care products, or exposure to microplastics. Conclusions: Higher serum levels of phthalates mECPP and mEOHP are correlated with increased lesion burden and disease activity in female MS patients within the first five years of disease onset. Fish intake was inversely correlated with serum levels of these phthalates. This study highlights how diet and exposures to environmental EDCs might partly explain sex differences in disease course in MS. Disclosure: Dr. Chuang has nothing to disclose. Ms. Feldman has nothing to disclose. The institution of Mr. Healy has received research support from Analysis Group. The institution of Mr. Healy has received research support from Bristol-Myers Squibb. The institution of Mr. Healy has received research support from Verily Life Sciences. The institution of Mr. Healy has received research support from Novartis. The institution of Mr. Healy has received research support from Merck Serono. The institution of Mr. Healy has received research support from Genzyme. Shrishti Saxena has nothing to disclose. Ms. Sanon has received personal compensation for serving as an employee of Brigham and Women’s Hospital . Ms. Saraceno has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cumming Foundation. The institution of Ms. Saraceno has received research support from I-Mab Biopharma. Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Chitnis has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche-Genentech. Dr. Chitnis has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Academic CME. The institution of Dr. Chitnis has received research support from Novartis. The institution of Dr. Chitnis has received research support from Sanofi. The institution of Dr. Chitnis has received research support from Octave.
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