Will Generation Alpha experience an increase in Multiple Sclerosis diagnoses?

Multiple Sclerosis (MS) is an autoimmune disease that affects the central nervous system. For those with the disease, their body’s immune system attacks the myelin sheath surrounding their nerve cells, often resulting in the killing of these cells. This leads to neuronal degeneration and potentially permanent neurological disability in MS patients. Whilst the cause for this condition remains unknown, there have been studies surrounding the potential that females with Vitamin D deficiencies may increase the risk of their child developing this disorder.

As someone who (since the age of 9) was instructed by my GP to take daily Vitamin D supplements, as well as having many friends who also have low Vitamin D levels, I found it interesting to research whether Generation Z’s increased prevalence for Vitamin D deficiencies, may put our at risk of increased MS diagnoses, and what this may mean for society.

A RISE IN VITAMIN D DEFICIENCIES

Studies have found an increase in the number of individuals with low vitamin D levels. This was an inevitable increase due to the increased lifestyle of working from home, especially since the pandemic. This has resulted in the decrease of exposure to sunlight, and in turn leaves these individuals with risks of developing Vitamin D deficiencies. Vitamin D has many health benefits for important functions in the body: bone health, preventing depression and anxiety, heart disease and hair loss.

In November 2022, a study of more than 4,000 people across the UK found that 42% of Brits in their 20s have a vitamin D deficiency, in comparison to only 21% of participants in their 60s and 12% in their 70s. These results were interesting as it is usually known that while ageing, the body becomes less able to assimilate certain vitamins from food, however these results suggest that Generation Z have a greater prevalence of Vitamin D deficiencies than older generations.

Vitamin D levels in the body are influenced by diet choice, nutrition and exposure to direct sunlight. However, as the convenience of remote working has become more popular in the recent years, many young people are beginning to become deficient in vitamins.

The COVID-19 pandemic certainly played a role in increasing the number of jobs that found alternative ways to function online, allowing their employees to work from home. Whilst this may have benefited these companies in many economic ways, socially and health-wise, there are many negatives. One main negative is the significant hours spent indoors, limiting the sunlight that these individuals get exposed to. Furthermore, living in the UK already involves most days having low levels of sunlight, which already raises the risks, however people not making efforts to make the most of the sunlight we get only does more harm. This is because Vitamin D synthesis in the lower epidermis of the skin is dependent on UVB radiation- obtained from sunlight.

WHY IS VITAMIN D DEFICIENCY IMPORTANT IN RELATION TO MULTIPLE SCLEROSIS?

Recent research has found that the risk of developing Multiple Sclerosis is greater in women whose mothers were vitamin D deficient during pregnancy. Reading about this, lead me to question whether the rise in vitamin D deficiencies among Generation Z may lead to the children of this generation being at a greater risk of developing this autoimmune disease.

In MS, demyelination occurs where the myelin sheath is damaged and this disrupts the conduction of action potentials, so that they are transmitted slowly or not at all. This occurs because the immune system recognises the body’s own myelin as foreign and attacks it, resulting in lesions or neuronal cell death: these can lead to the various symptoms of the condition.

In the abnormal immune response of MS, there are different immune cells which are involved. Myelin-specific T cells (from the body’s immune system) release pro-inflammatory chemicals, which are called cytokines. These cytokines cause inflammation and damage as they assume the myelin sheath is foreign. Alongside these pro-inflammatory T cells, there are T regulatory cells which can turn off inflammation, to regulate the level of immune response.

However, in MS, researchers believe that the auto-immune response is caused by a dysregulation in the functions of the T regulatory cells as they do not function properly, therefore are unable to dampen the inflammatory response. This results in a heightened immune response that can’t be managed by the T regulatory cells leading to increased inflammation and damage, forming CNS lesions (which can be visible on brain scans).

In order for these myelin-specific T cells to cause this damage in the CNS, they have to pass through the blood-brain barrier in order to reach the neurones in the CNS. The myelin-specific T cells can move through because of the expression of chemokine receptors and the secretion of chemokines, as well as the production of particular cytokines by these T cells that can further promote blood-brain barrier permeability by disrupting tight junctions of the endothelium.

The link to Vitamin D is that T cells express vitamin D receptors, therefore vitamin D can regulate the development and function of T cells. Additionally, vitamin D can stimulate the development of T regulatory cells, whilst also suppressing the development of myelin-specific T cells. This correction in the balance of these two types of T cells will reduce the inflammation and manage it better. Therefore, this implies that vitamin D could reduce demyelination and CNS inflammation as there will be reduced formation of lesions. Vitamin D also reduces the production of chemokines, meaning that this could prevent myelin-specific T cells from migrating into the CNS in the first place.

SOLUTION/ CONCLUSIONS

Due to these findings of vitamin D’s link to the autoimmune response in MS, several human clinical trials have take place to assess the therapeutic effect of vitamin D on MS. So far, the results are insufficient to give firm evidence to support the therapeutic efficacy of using vitamin D supplements. However, one of the largest studies that examined the use of vitamin D as a therapy, found a 32% decrease in lesions in the brains of MS patients.

Whilst we can not conclude whether vitamin D supplements should be encouraged to Generation Z in order to reduce their progression (as well as their child’s likelihood of developing) MS, the MS Society in the UK is supporting research into its potential benefits.

Potentially, in a few years, it may be found that most of the population will be encouraged to spend a minimum number of hours each week outdoors and to take daily vitamin D tablets in order save the public from the risk of a dangerous increase in this degenerative disease.