Environmental and genetic risk factors in the development of neuromyelitis optica

ABSTRACT

Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease mainly characterized by the optic nerve and spinal cord involvement. The mentioned disorder has peculiar characteristics as it is a kind of astrocytopathy and the antibody against water channels plays a major role in its pathogenesis.

Areas covered: This review covers the different genetic and environmental risk factors for NMOSD. The disease has a wide diversity in terms of lesions, symptoms, age of involvement, and presence of anti-aquaporin 4 antibody (Anti-AQ4). NMOSD has been classified into two types of seropositive and seronegative depending on the presence or absence of Anti-AQ4. As a result, this study reviews various genetic and environmental risk factors of NMOSD according to Anti-AQ4 status.

Expert opinion: This review indicated that NMOSD disease has its specific risk factors. These risk factors may include vitamin D insufficiency, smoking, infections, and dietary habits.

Another very important issue reported in these studies was the diversity of risk factors, whether genetic or environmental, in seropositive and seronegative patients. Identification of the risk factors and their modification can help reduce the risk of NMOSD.

KEYWORDS:

• NMOSD
• genetic risk factors
• environmental risk factors
• diet
• infections
• smoking
• vitamin D

Article highlights

• NMOSD has its specific genetic and environmental risk factors.

• These risk factors differ according to Anti-AQ4 status.

• It seems that environmental risk factors play more important roles in the pathogenesis of NMOSD.

• Identification of the risk factors and their modification can help reduce the risk of NMOSD.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.