What is the strongest evidence that Multiple sclerosis is not entirely genetically controlled:

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To evaluate the question, let's consider what would indicate that MS is not entirely genetically controlled.
Option 1: 'MS is five times more prevalent in temperate zones than near the equator.' This geographic distribution suggests environmental factors (like sunlight exposure/vitamin D) play a role, but it does not directly measure genetic control. It supports non-genetic influences but is not the strongest single piece of evidence about genetic contribution.
Option 2: 'Siblings have 10 to 15 times higher incidence.' While this shows familial aggregation, siblings share roughly 50% of their genes on average, which could reflect genetic factors, shared environment, or both. It does indicate heritability but does not pinpoint the limit of genetic control by itself, and the magnitude can be influenced by environment.
Option 3: 'HLA Immune patterns of MS patients tend to be different from normal subjects.' This points to specific immune-related genetic associations (like HLA), supporting a genetic component to susceptibility. However, the presence of an associated pattern still allows substantial environmental interaction, and by itself it doesn’t quantify how much is genetic versus environmental.
Option 4: '2 of 3 cases occur in women.' This speaks to sex differences or gender-related risk factors but does not directly address the overall degree of genetic control; it could reflect hormonal, environmental, or genetic factors. It’s informative about epidemiology but not a measure of heritability.
Option 5: 'Only ~30 percent of identical twins both have Multiple sclerosis' This is the strongest single indicator that genetics is not the sole determinant. Identical twins share nearly all their genes, so if MS were fully genetically determined, we would expect nearly all twin pairs to both be affected. The fact that only about 30 percent concordance demonstrates a substantial environmental or non-genetic contribution to disease risk, making it the best evidence among the options that MS is not entirely genetically controlled.

01:146:447:01 CLINICAL NEUROBIO CN F25 Exam 2

What is the strongest evidence that Multiple sclerosis is not entirely genetically controlled:

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