(Barcelona, Spain, Thursday, 25 September 2025) Children exposed to higher levels of air pollutants face a significantly increased risk of developing paediatric multiple sclerosis (pedMS), new research presented today at the 41st Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS 2025) has shown [1].
The Italian multicentre PEDIGREE study assessed environmental and perinatal exposures using the PEQ-IT questionnaire alongside air pollution data from the European Monitoring and Evaluation Programme. The research analysed data from 113 children with pedMS (77% female; mean age 16.8 years) and 117 controls (55% female; mean age 13.8 years).
Analyses showed a significant association between higher ozone exposure and pedMS in the first, second and third year before disease onset. For every unit increase in ozone exposure, the risk of pedMS rose by about 10%, and this association remained statistically significant after adjusting for age, sex, sun exposure, parental smoking and socioeconomic level.
MS is a multifactorial disease in which both genetic and environmental factors contribute to disease onset [2]. While air pollution has previously been implicated in MS risk in adults [3], its role in paediatric MS has been less clear.
“Children are particularly vulnerable to ozone exposure, which is often highest during warm weather and outdoor activities,” explained lead author Dr Maura Pugliatti. “Our findings suggest that ozone is an independent risk factor for paediatric MS, likely through mechanisms such as oxidative stress, pro-inflammatory cytokine release, and impaired biological barriers.”
The investigators noted that this is the first study to report a consistent association between ozone exposure and MS risk in a paediatric population. Further research is planned to expand the study cohort, validate questionnaire-based findings with biological measurements, and explore the role of other environmental pollutants, including air and water exposures.
“Ultimately, this work highlights the importance of considering environmental health in MS risk,” said Dr Pugliatti. “By better understanding environmental triggers, we can inform public health strategies to reduce exposure and protect children at risk.”
ENDS
About ECTRIMS 2025:
ECTRIMS 2025 – held on 24-26 September at the CCIB Barcelona International Convention Center in Barcelona, Spain – is the premier meeting place for researchers, clinicians and healthcare providers to collaborate on life-changing research and treatment options for people with MS and related diseases. This year’s programme offers top-tier scientific sessions, education, networking, and more.
Discover more: https://ectrims.eu/ectrims2025
About the study author:
Dr Maura Pugliatti is a neurologist and researcher at the University of Ferrara, Italy. Her work focuses on the epidemiology of MS and related neuroinflammatory diseases, with a particular emphasis on environmental and lifestyle risk factors. She is among the key investigators in the PEDIGREE study, a multicentre initiative exploring the interplay of environmental exposures and genetic predisposition in the development of paediatric MS.
References:
- Pugliatti M, Bergamaschi R, Pilotto A, Ghezzi A, et al. Exposure to ozone is associated with an increased risk of pediatric multiple sclerosis (pedMS): the PEDIGREE study. Abstract IMS25-LBA-176. Presented at ECTRIMS 2025, Barcelona, Spain.
- Waubant, E., Lucas, R., Mowry, E., Graves, J., Olsson, T., Alfredsson, L., & Langer-Gould, A. (2019). Environmental and genetic risk factors for MS: an integrated review. Annals of clinical and translational neurology, 6(9), 1905–1922.
- Lavery, A. M., Waubant, E., Casper, T. C., Roalstad, S., Candee, M., Rose, J., Belman, A., Weinstock-Guttman, B., Aaen, G., Tillema, J. M., Rodriguez, M., Ness, J., Harris, Y., Graves, J., Krupp, L., Charvet, L., Benson, L., Gorman, M., Moodley, M., Rensel, M., … Waldman, A. T. (2018). Urban air quality and associations with pediatric multiple sclerosis. Annals of clinical and translational neurology, 5(10), 1146–1153.