Revue médicale de Liège
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Revue médicale de Liège · May 2012
Review[Vitamin D tweets light to genes in multiple sclerosis].
The relationship between sunlight exposure and the incidence of multiple sclerosis and the understanding of immunomodulatory effects of vitamin D triggered, in recent years, a broad range of investigations. Immunological studies performed in vitro and in vivo have demonstrated how tolerogenic vitamin D can be. Epidemiological studies confirmed an increased incidence of multiple sclerosis in vitamin D deficient subjects and signs of increased disease activity in such MS patients. Although small-scale observational studies have suggested a beneficial impact of vitamin D supplementation on the incidence and severity of multiple sclerosis, large scale clinical trials remain warranted to confirm these preliminary results.
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Migraine is a frequent neurological syndrome with a heterogenous clinical presentation. Its pathophysiology remains poorly understood but a genetic aetiology has been suspected for a long time, as well as a significant influence of the environment. Familial hemiplegic migraine belongs to monogenic migraines, which are very rare entities with an autosomal dominant transmission. ⋯ The environmental contribution (endogenous or exogenous) is much more pronounced in the common forms of migraine, with the identification of numerous predisposing or triggering factors, among which only some can be avoided. Finally, a recent behavioural hypothesis coming from adaptative darwinian theories has proposed a genetic-environment integrative model for common migraine. The latter would result of hereditary physiological adaptative defence mechanisms which would be progressively impaired by repeated brain homeostasis imbalances due to the environment.