Author: Romella Durrani
Imagine you are a woman in her 30s and have spent your whole life in Alberta. You have a range of health concerns that are unpredictable, and you are beginning to experience muscle weakness, numbness and tingling in your limbs, loss of coordination and balance, loss of vision, and you feel your memory and cognitive abilities have declined in recent years, beyond what is expected for your age. You go to your doctor and get diagnosed with a disease called Multiple Sclerosis, also known as MS. Your doctor explains to you that MS is a neurological autoimmune disease that causes the immune system to attack the protective insulator (myelin sheath) that is wrapped around your neurons. This protective layer functions like the protective insulator around electrical wires, which allows signals to pass through faster and more efficiently. When this protective insulator is lost or damaged, like in MS, this is termed as demyelination, which causes your nervous system to malfunction.
Now imagine another woman also lives in Alberta, but she migrated to Alberta as an adult. This woman has no signs or symptoms consistent with MS and thus does not have MS. What makes these two women different? Is one woman more susceptible to MS than another?
As of 2015, it is estimated that 2.3 million people suffer from MS worldwide and 100,000 in Canada. Canada has one of the highest rates of MS in the world, but Alberta specifically, has the highest rates in the country. This makes Alberta the MS capital of the world in terms of prevalence, which raises concern since this crisis causes devastating quality of life issues for many Albertans. These alarming MS rates put many Albertans at risk. Additionally, women are 2.5 times more likely to be affected than men. This could all mean that it is probable that a woman that has lived in Alberta her whole life has a much higher risk of developing MS compared to a woman who moved to Alberta as an adult.
Many patients with MS will experience a loss in muscle strength and may have to use wheelchairs in their daily life.
What makes Canada and specifically Alberta, so different for MS risk? It is thought that MS is caused and influenced by genetic and environmental factors. Some studies link vitamin D deficiency to MS, suggesting that low vitamin D levels play a role in the loss of nerve cell protective myelin cover. This can be exemplified through the prevalence of MS predominantly occurring in regions coinciding with reduced sun exposure, such as Canada and many Scandinavian countries, which results in low vitamin D levels. These regions also coincide with the highest rates of MS, suggesting a correlation. Adequate levels of vitamin D can prevent the development or worsening of autoimmune responses. This in turn prevents the immune system from attacking the myelin sheath and prevents inflammation that can cause further loss of the myelin sheath.
Vitamin D may exert a protective role through receptors that are expressed by immune cells, allowing vitamin D to regulate immune responses. Vitamin D has been shown to modulate our first line of response against injury and inflammation (innate immune cells) and produce tolerance, thus stopping our body to attack itself as it is in the case in MS. On the flipside, low vitamin D levels have been shown as one of the links to MS progression. Additionally, environmental triggers and toxins can lead to reactive immune responses, resulting in an autoimmune response that can attack the protective myelin sheath.
The immune system plays a major role in MS, and factors that can improve the immune system and inhibit self-destruction immune responses can help prevent demyelination progression. Building up a good immune system that is less susceptible to environmental triggers, and having adequate levels of vitamin D, may possibly lower the likelihood of developing MS, especially in high risk areas like Alberta.