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. 2013 Dec 11;8(12):e74259.
doi: 10.1371/journal.pone.0074259. eCollection 2013.

Multiple Sclerosis in the Mount Etna region: possible role of volcanogenic trace elements

Alessandra Nicoletti  1 , Elisa Bruno  1 , Martina Nania  1 , Edoardo Cicero  1 , Silvia Messina  1 , Clara Chisari  1 , Josita Torrisi  1 , Davide Maimone  2 , Roberto Marziolo  3 , Salvatore Lo Fermo  1 , Francesco Patti  1 , Salvatore Giammanco  4 , Mario Zappia  1
Affiliations

Multiple Sclerosis in the Mount Etna region: possible role of volcanogenic trace elements

Alessandra Nicoletti et al. PLoS One. .

Erratum in

  • PLoS One. 2014;9(6):e100942

Abstract

Background: Trace elements have been hypothesised to be involved in the pathogenesis of Multiple Sclerosis and volcanic degassing is the major natural sources of trace elements. Both incidence of Multiple Sclerosis in Catania and volcanic activity of Mount Etna have been significantly increased during the last 30 years. Due to prevailing trade winds direction, volcanic gases from Etna summit craters are mostly blown towards the eastern and southern sectors of the volcano.

Objective: To evaluate the possible association between Multiple Sclerosis and exposure to volcanogenic trace elements.

Methods: We evaluated prevalence and incidence of Multiple Sclerosis in four communities (47,234 inhabitants) located in the eastern flank and in two communities (52,210 inhabitants) located in the western flank of Mount Etna, respectively the most and least exposed area to crater gas emissions.

Results: A higher prevalence was found in the population of the eastern flank compared to the population of the western one (137.6/100,000 versus 94.3/100,000; p-value 0.04). We found a borderline significantly higher incidence risk during the incidence study period (1980-2009) in the population of the eastern flank 4.6/100,000 (95% CI 3.1-5.9), compared with the western population 3.2/100,000 (95% CI 2.4-4.2) with a RR of 1.41 (95% CI 0.97-2.05; p-value 0.06). Incidence risks have increased over the time in both populations reaching a peak of 6.4/100,000 in the eastern flank and of 4.4/100.000 in the western flank during 2000-2009.

Conclusion: We found a higher prevalence and incidence of Multiple Sclerosis among populations living in the eastern flank of Mount Etna. According to our data a possible role of TE cannot be ruled out as possible co-factor in the MS pathogenesis. However larger epidemiological study are needed to confirm this hypothesis.

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Conflict of interest statement

Competing Interests: M. Zappia has received compensation for consulting services from Boehringer-Ingelheim, Lundbeck, Union Chimique Belge and scientific grants from AIFA- Agenzia Italiana del Farmaco, Novartis, Lundbeck. M. Zappia is the holder of the following patent, Movement Time Analyzer 01277716 issued by the Ministry of the Italian the 12 of November 1997. A. Nicoletti has received honoraria from UCB-Union Clinique Belge for medical education symposia and Lundbeck. F. Patti has received honoraria for speaking activities by Bayer Schering, Biogen Idec, Merck Serono, Novartis and Sanofi Aventis; he also served as advisory board member the following companies: Bayer Schering, Biogen Idec, Merck Serono, Novartis; he was also funded by Pfizer and FISM for epidemiological studies; finally he received grants for congress participation from Bayer Schering, Biogen Idec, Merck Serono, Novartis, Sanofi Aventis and TEVA. S. Lo Fermo received honoraria for speaking activities from Biogen Idec, Merck Serono; he also received grants for congress participation from Bayer Schering, Biogen Idec, Merck Serono and Sanofi Aventis. E. Bruno, M. Nania, E. Cicero, S. Messina, C. Chisari, J. Torrisi, D. Maimone, R. Marziolo, S. Giammanco have nothing to disclose. There are no further patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Age and sex distribution of the study population (census 2011).
Figure 2
Figure 2. Average annual onset/adjusted incidence risk of MS in the populations of the western and eastern flanks of Mount Etna during the incidence study period.
See this image and copyright information in PMC

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