European Neurology 47:1:2002, 52-55.
Franz X. Weilbach, Klaus V. Toyka
Department of Neurology, Clinical
Research Group for Multiple Sclerosis and Neuroimmunology, Julius Maximilians
University, Würzburg, Germany
Background:
A higher incidence of certain autoimmune
disorders has been reported in Down's syndrome (DS) but only 1 case of
DS associated with multiple sclerosis (MS) has been published to date.
Methods:
We performed a calculation based
on population and prevalence data of each condition to estimate the expected
coprevalence of both diseases. As no published data on DS prevalence are
available, a rough estimate was calculated from live birth rates and published
life tables.
Results:
In a total of 116,939 assumed cases
of patients with DS in Western Europe 102 patients with concordant MS would
be expected at any time point according to the incidence of MS, but only
1 case was reported.
Conclusion and Hypothesis:
We propose the hypothesis that despite
a propensity in DS for certain autoimmune diseases there is a negative
association of DS and MS. Genes located on chromosome 21 may thus confer
protection against MS. Candidate genes for protective immunomodulation
might include interferon receptor I and II and S100b. Substantiated by
further epidemiologic data, the identification of these and other chromosome
21 gene products may provide new hints for the understanding of modulatory
genes in the pathogenesis of MS. In more general terms, this negative association
also may allow to study basic principles of how certain candidate genes
might act on autoimmune disease expression.
Copyright © 2002 S. Karger AG,
Basel