Viral infections trigger multiple sclerosis relapses: a prospective seroepidemiological study.
A neurological surveillance was combined with prospective recording of upper respiratory and gastrointestinal infections and serological diagnosis of five common viral infections in 60 benign multiple sclerosis patients, with a mean follow-up of 31 months. During 4-week at risk (AR) periods encompassing common infections, a significant excess of MS relapses was found in the AR period, with a relative risk of 1.3. A seasonal variation of the MS relapse rate was found with a minimum in summer. There was a significant correlation between the number of AR relapses and the number of common infections per month explaining the periannual distribution of relapses. The non-AR relapses showed no seasonal variation. There was a significant correlation between adenovirus CF titre rises associated with upper respiratory infections and the occurrence of a major MS relapse in the AR period (n = 7), while influenza infections were not followed by a major MS relapse (n = 6). Linear homologies have been demonstrated between adenovirus and basic myelin protein. The epidemiological approach is essential to our understanding of systemic antigens triggering multiple sclerosis activity.
Andersen
O
O
Department of Neurology, University of Gothenburg, Sweden.
Lygner
P E
PE
Bergström
T
T
Andersson
M
M
Vahlne
A
A
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications* / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D012698:Serologic Tests; D014777:Virus Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology