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Epstein-Barr causes MS but requires help

Gene–environment interactions: Epstein–Barr virus infection and risk of pediatric-onset multiple sclerosis; Multiple Sclerosis Journal, Feb. 9, 2024.

Epstein-Barr virus (EBV) infection is a leading cause of adult and pediatric multiple sclerosis (MS), but the mechanism is unclear.

Researchers affiliated with the Network of Pediatric Multiple Sclerosis Centers sought to explain how a viral infection nearly every human gets affects only 0.3% of the population in that manner.

Investigators examined data from 473 pediatric MS cases and 702 controls from the Environmental and Genetic Risk Factors for Pediatric MS study. Although their study failed to answer the question of causation it uncovered new additive relationships between prior EBV infection, type of anti-EBV response and two genetic risk factors associated with susceptibility to MS.

First, individuals with MS were more than 50% more likely (94.6% vs. 60.7%) to have antibodies to the virus’ capsid antigen, which is normally a sign of a new or active infection.

Second, previously infected subjects whose immune cells carry one specific gene family, DRB1*15, were 10 times as likely to develop MS as individuals with prior infection or the DRB1*15 gene alone. Having multiple DRB1 genes multiplied the effect.

One form of DRB1*15, DRB1*15:01, has a strong association with MS and may be considered a “genetic predisposition” for the disease. For example, DRB1*15:01 was found in all MS-affected members of one Italian family and 4 of 5 unaffected family members.

Finally, prior infection plus one specific mutation in the CD86 gene, which regulates antibody production, results in a 30% increased risk for pediatric MS.

So while genes play a role, EBV infection appears to be a necessary precondition for developing MS.

Inflammation during pregnancy may predict child’s depression

Sex-Specific Pathways From Prenatal Maternal Inflammation to Adolescent Depressive Symptoms; JAMA Psychiatry, Feb. 7, 2024.

A long-term observational study found a positive association between prenatal maternal inflammation (PNMI) and depressive symptoms in adolescent offspring years later.

Investigators evaluated frozen blood samples, collected from 674 pregnant women between June 1959 and September 1966, for four cytokine markers of PNMI associated with psychiatric symptoms: interleukin-6 (IL-6), IL-8, IL-1RA and soluble tumor necrosis factor receptor-II (sTNF-RII).

Then, between 1977 and 1979 (corresponding to children ages 15-17), mothers completed a 100-item questionnaire on their children’s behavior during childhood. The children completed self-evaluation surveys. Of 675 offspring remaining in the study, 350 were male.

Of particular interest were “internalizing” and “externalizing” symptoms — psychiatric shorthand for maladaptive behaviors involving self (withdrawal, anxiety, depression) or interactions with one’s social environment (aggression, impulsivity, hyperactivity), respectively.

Researchers expected inflammatory markers to have greater predictive power for boys than girls. They found instead that both sexes were affected but in different ways.

They found that elevated IL-6 during the first trimester was associated with childhood externalizing symptoms in males, while IL-6 levels during the second trimester predicted internalizing symptoms in females.

Investigators also found an association between second-trimester IL-1RA levels and internalizing symptoms, but only in females.

Ibuprofen fails to improve congenital heart defect

Trial of Selective Early Treatment of Patent Ductus Arteriosus with Ibuprofen; New England Journal of Medicine, Jan. 25, 2024.

Ibuprofen, an over-the-counter nonsteroidal anti-inflammatory pain reliever, has been called the “drug of choice” for treating patent ductus arteriosus (PDA), a congenital heart defect in preterm infants.

But does the drug even work?

An international research team affiliated with the ongoing Baby-OSCAR Collaborative Group study recruited 653 preterm (between 23 and 29 weeks gestation) babies with PDA and assigned 326 to receive ibuprofen and 327 to receive a placebo.

PDA is an opening between the heart’s two main blood vessels. The study’s main endpoints were death or bronchopulmonary dysplasia (BPD), a serious lung disorder requiring oxygen therapy.

While PDA is congenital, BPD develops only after lung damage has occurred.

Ibuprofen easily lost this competition. The study showed that 69.2% of babies in the treatment group experienced either death or BPD, compared with 63.5% of placebo babies.

Among babies who survived, 64.2% of treated kids developed mild or serious BPD, compared with 59.3% in the placebo group. Even worse, 44 treated children (13.6% of those eligible for evaluation) versus 33 untreated children (10.3%) died.

Small comfort: None of these results, including 11 extra dead babies, met statistical significance.

Another health risk from ultra-processed foods

Ultra-processed and fast food consumption, exposure to phthalates during pregnancy, and socioeconomic disparities in phthalate exposures; Environment International, Jan. 6, 2024.

Ultra-processed foods wreak havoc on human health but their nutritional emptiness and artificial ingredients may not be their least appealing features, according to a U.S. study.

As part of the Conditions Affecting Neurocognitive Development and Learning in Early childhood (CANDLE) study, researchers administered the Block Food Frequency Questionnaire to 1,031 “socioeconomically diverse” pregnant women and tested them for urinary concentrations of phthalate breakdown products (metabolites) during their second trimester.

Ultra-processed foods comprised around 39% of participants’ diets.

Phthalates are plastics used in film-type packaging, plastic bags and food-contact plastic coatings (for example inside drink cans).

A 10% increase in consumption of ultra-processed foods was associated with 13.1% higher urine concentrations of phthalate metabolites, whereas eating 10% more minimally-processed foods was associated with 10.8% lower concentrations of phthalate metabolites.

Are COVID immunizations vaccinating your fetus?

Transplacental Transmission of the COVID-19 Vaccine mRNA: Evidence from Placental, Maternal and Cord Blood Analyses Post-Vaccination; American Journal of Obstetrics and Gynecology, Jan. 24, 2024 (journal pre-proof). 

COVID-19 immunization products (“vaccines”) were supposed to stay at the injection site. However, according to a New York University study, vaccine messenger RNA (mRNA) and coronavirus spike protein can reach placentas and umbilical cords in pregnant women.

This study involved just two patients. Patient 1, a 34-year-old pregnant woman, received a Pfizer two-shot primary round and two boosters (one Pfizer, one Moderna), with the last dose administered two days before delivering by cesarean section. Investigators collected samples of her placenta, blood and cord blood post-delivery.

Patient 2 was 33 and received two Pfizer doses, the last 10 days before her vaginal delivery. Only placental samples were available from this patient.

Vaccine mRNA was detected in both placentas. Spike protein was found in the placenta of Patient 2 but not Patient 1. mRNA from the vaccine was found in the cord and maternal blood of Patient 1.

The authors concluded: “These two cases demonstrate, for the first time, the ability of the COVID-19 vaccine mRNA to penetrate the fetal-placental barrier and reach the intrauterine environment.”