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Research paper
Food allergies are associated with increased disease activity in multiple sclerosis
  1. Rami Fakih,
  2. Camilo Diaz-Cruz,
  3. Alicia S Chua,
  4. Cindy Gonzalez,
  5. Brian C Healy,
  6. Neda Sattarnezhad,
  7. Bonnie I Glanz,
  8. Howard L Weiner,
  9. Tanuja Chitnis
  1. Partners MS Center, Brigham and Women's Hospital (BWH), Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Tanuja Chitnis, Partners Multiple Sclerosis Center, Boston, MA 02115, USA; tchitnis{at}


Objective The association between allergy and multiple sclerosis (MS) is still unclear. In our study, we assessed the association between a self-reported history of allergic conditions with MS clinical and MRI disease activity.

Methods A subset of 1349 patients enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women’s Hospital (CLIMB) study completed a self-administered questionnaire on environmental, food and drug allergies. Patients were distributed among four allergy groups: (1) environmental, (2) food, (3) drug, (4) no known allergies (NKA). Clinical (number of attacks, expanded disability status scale (EDSS), MS severity score (MSSS)) and radiological variables (presence of gadolinium-enhancing lesions and lesion count), and their associations with the different allergy groups or those with NKA, were assessed.

Results The food allergy group had a 1.38 times higher rate for cumulative number of attacks compared with the NKA group (P=0.0062); this difference remained significant in the adjusted analysis (relapse rate ratio 1.27, P=0.0305). The food allergy group showed more than twice the likelihood (OR 2.53, P=0.0096) of having gadolinium-enhancing lesions on MRI. The environmental and drug allergy groups did not show significant differences when compared with the NKA group. The EDSS and MSSS were not affected by any type of allergy.

Conclusions MS patients with food allergy had more relapses and a higher likelihood of gadolinium-enhancing lesions compared with patients with no known allergy. Future prospective studies are needed to confirm our findings and investigate underlying biological mechanisms, which may unveil new therapeutic and preventative strategies for MS.

  • food allergy
  • multiple sclerosis
  • disease activity
  • relapses
  • MRI

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  • Contributors Study concept and design: TC, CDC. Additional study design: RF. Data collection, validation and analysis: CDC, ASC, RF, CG, NS. Additional analysis design and data interpretation: CG, BCH. Drafting of the manuscript: RF. Critical revision of the manuscript: All authors. Study participant enrolment: BIG. Study supervision: TC, HLW. All co-authors gave their approval of the manuscript to be published.

  • Funding We thank Merck Serono and the National MS Society Nancy Davis Center Without Walls for their support of the CLIMB study.

  • Competing interests RF reports no conflict of interests. CDC reports no conflicts of interests. ASC reports no conflict of interests. CG reports no conflicts of interests. BCH reports grants from Verily Life Sciences, grants from Novartis, grants from Merck Serono, grants from Genentech, outside the submitted work. NS reports no conflicts of interests. BIG reports grants from Merck Serono, during the conduct of the study, and grants from Verily Life Sciences, outside the submitted work. HLW reports support from NIH, NMSS, Verily Life Sciences, EMD Serono, Biogen, Teva Pharmaceuticals, Sanofi, and Novartis. Research support and consulting fees from Genentech, Inc, Tilos Therapeutics, Tiziana Life Sciences, and IM Therapeutics. Personal and consulting fees from vTv Therapeutics and MedDay Pharmaceuticals. TC reports consulting fees from Biogen Idec, Novartis, Sanofi, Bayer, and Celgene, outside the submitted work.

  • Patient consent Not required.

  • Ethics approval The Partners Institutional Review Board approved this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data used in this manuscript are available to qualified health care professionals under the guidance of the Partners Human Research Committee and Partners Data Use Agreements.

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