HLA antigens in multiple sclerosis.
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Biomedical subjects
Publications and source records attributed to M Alter.
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Comparisons between the geographic distribution of multiple sclerosis and the habitats of various racial groups showed that racial factors alone could not explain the increase in prevalence of the disease with latitude. Racially similar groups living in different areas had different frequencies of multiple sclerosis. Conversely, racially different groups, living in the same area, had similar prevalence rates of multiple sclerosis. Moreover, migrants moving from one environment to another at a young age (before adolescence) appeared "to acquire" the risk of multiple sclerosis of the new environment. These observations suggest than an environmental factor independent of race influenced the risk of acquiring multiple sclerosis. Nonetheless, some genetic factors associated with race may also be implicated, for example, HL-A tissue antigens (perhaps by virtue of a common association with the immune response (Ir) gene), the Gm and Inv immunoglobulin characteristics and skin pigmentary characteristics (perhaps through interactions between pigmentation and calcium metabolism). The specific environmental factors determining risk of multiple sclerosis and the mechanism whereby the racial (genetic) factors may influence risk remain to be elucidated.
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During the period 1968-73, 46 patients with subacute sclerosing panencephalitis (SSPE), a fatal childhood disease related to rubeola, were encountered in Israel. The incidence per million population was 3.4 for Sephardic Jews, 3.2 for Arabs and only 0.5 for Ashkenazic Jews. An environmental factor which sharply demarcated Arabs and Sephardic Jews from Ashkenazic Jews, and which might account for the differences in incidence of SSPE, was family size: 42.3% of Arab families and 21.5% of the families of Sephardic Jews but only 1.1% of Ashkenazic Jewish families had five or more children. It is postulated that older siblings in large families might constitute vectors which introduce rubeola to the younger siblings at a time when they are at unusual risk of developing SSPE (i.e. before two years of age), whereas in small families, rubeola tends to be acquired later in childhood when the risk of SSPE is reduced.
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A countrywide search for Creutzfeldt-Jakob disease in Israel disclosed 29 cases with onset between 1963 and 1972. Incidence in various ethnic groups varied in the narrow range of 0.4 to 1.9 per million population except among Jewish immigrants from Libya, among whom the incidence was 31.3 per million. An extraordinary excess of Creutzfeldt-Jakob disease exists in this ethnic group.
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