Seasonal Influences on Multiple Sclerosis Pathophysiology

Multiple sclerosis (MS) exhibits a notable seasonal pattern in both clinical expression and underlying pathophysiology. The interplay between environmental factors and immune regulation underpins variations in relapse frequency and symptom severity across the year. Seasonal fluctuations in ultraviolet radiation modulate cutaneous synthesis of vitamin D, which in turn influences the activity of the vitamin D receptor within immune cells, shifting the balance between pro-inflammatory and regulatory pathways. Concurrent changes in ambient temperature and humidity affect nerve conduction and may exacerbate conduction block in demyelinated fibres. At the cellular level, seasonal alterations in serum metabolites and cytokine profiles reflect shifts in energy metabolism, such as a relative increase in glycolysis and activation of bioactive lipids. Peaks in relapse rates often coincide with periods of lower sun exposure and cooler temperatures, while summer months tend to present fewer exacerbations, although heat exposure can transiently worsen symptoms. Understanding these seasonal influences has practical relevance for optimising treatment timing, guiding lifestyle interventions and informing public health strategies worldwide.

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Seasonal Influences on Multiple Sclerosis Pathophysiology publication trend

The graph below shows the total number of articles in seasonal influences on multiple sclerosis pathophysiology across all publications each year (not limited to Nature Index journals).

Technical terms

Metabolomics: The large-scale study of small molecules within biological samples, reflecting dynamic physiological processes.

Ceramides: A class of bioactive sphingolipids involved in cell signalling, apoptosis and inflammation.

Glycolysis: A central energy-yielding metabolic pathway that converts glucose to pyruvate under aerobic or anaerobic conditions.

Quinolinic acid: A neuroactive metabolite of the kynurenine pathway implicated in excitotoxicity and inflammatory responses in the central nervous system.

Vitamin D receptor (VDR): A nuclear hormone receptor that mediates the genomic effects of vitamin D on immune and non-immune cells.

References

1. Seasonal Changes in Serum Metabolites in Multiple Sclerosis Relapse. International Journal of Molecular Sciences (2023).
2. Triggering multiple sclerosis at conception and early gestation: The variation in ultraviolet radiation is as important as its intensity. Heliyon (2023).
3. Seasonal variation in multiple sclerosis relapse. Journal of Neurology (2017).
4. Heat Exposure and Multiple Sclerosis—A Regional and Temporal Analysis. International Journal of Environmental Research and Public Health (2021).