Infection and the etiology and pathogenesis of multiple sclerosis.
Multiple sclerosis (MS) currently defies clinical and scientific definitions, and carries a prognosis that remains practically unchanged despite many years of intensive research. Although the prevailing dogma is that MS is an immune-mediated condition, it fulfills none of the criteria of an autoimmune disease. On the other hand, there is enough significant data to suggest that infectious agents(s) could be involved in either direct damage to the white matter or induce inflammatory responses that secondarily affect the brain. Our goal here is to review the data supporting the possibility that infection has a critical role in the disease, examine the list of potential candidates that have been suggested, and outline an approach regarding the potential role of infectious agents in the etiology and pathogenesis of MS.
Steiner
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Department of Neurology, Hadassah University Hospital, PO Box 12000, Jerusalem 91120, Israel.
Nisipianu
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Wirguin
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D000328:Adult; D000818:Animals; D001324:Autoantigens / Q000276:immunology; D001327:Autoimmune Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D001921:Brain / Q000473:pathology; D002648:Child; D023521:Chlamydophila Infections / Q000150:complications; D016993:Chlamydophila pneumoniae / Q000472:pathogenicity; D016000:Cluster Analysis; D020031:Epstein-Barr Virus Infections / Q000150:complications; D015654:Herpesvirus 6, Human / Q000472:pathogenicity; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007239:Infections / Q000150:complications* / Q000276:immunology; D016899:Interferon-beta / Q000627:therapeutic use; D008213:Lymphocyte Activation; D008262:Macrophage Activation; D018716:Molecular Mimicry; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D009186:Myelin Sheath / Q000276:immunology / Q000473:pathology; D020721:Nervous System Autoimmune Disease, Experimental; D018410:Pneumonia, Bacterial / Q000150:complications / Q000382:microbiology; D012192:Retroviridae Infections / Q000150:complications; D019349:Roseolovirus Infections / Q000150:complications / Q000821:virology; D013116:Spinal Cord / Q000473:pathology
D001324:Autoantigens; D007155:Immunologic Factors; D016899:Interferon-beta