Early-life hygiene-related factors affect risk of central nervous system demyelination and asthma differentially.

The increasing prevalence of immune-related diseases, including multiple sclerosis, may be partly explained by reduced microbial burden during childhood. Within a multi-centre case-control study population, we examined: (i) the co-morbid immune diseases profile of adults with a first clinical diagnosis of central nervous system demyelination ( FCD) and (ii) sibship structure in relation to an autoimmune ( FCD) and an allergic (asthma) disease. FCD cases ( n = 282) were aged 18-59 years; controls ( n = 558) were matched on age, sex and region. Measures include: history of doctor-diagnosed asthma; sibling profile (number; dates of birth); and regular childcare attendance. FCD cases did not differ from controls with regard to personal or family history of allergy, but had a greater likelihood of chronic fatigue syndrome [odds ratio ( OR) = 3·11; 95% confidence interval ( CI) 1·11, 8·71]. Having any younger siblings showed reduced odds of FCD ( OR = 0·68; 95% CI: 0·49, 0·95) but not asthma ( OR = 1·47; 95% CI: 0·91, 2·38). In contrast, an increasing number of older siblings was associated with reduced risk of asthma ( P trend = 0·04) but not FCD ( P trend = 0·66). Allergies were not over-represented among people presenting with FCD. Sibship characteristics influence both FCD and asthma risk but the underlying mechanisms differ, possibly due to the timing of the putative 'sibling effect'. [ABSTRACT FROM AUTHOR]