title: Viruses and multiple sclerosis.
abstract: Multiple sclerosis (MS) is a heterogeneous disease that develops as an interplay between the immune system and environmental stimuli in genetically susceptible individuals. There is increasing evidence that viruses may play a role in MS pathogenesis acting as these environmental triggers. However, it is not known if any single virus is causal, or rather several viruses can act as triggers in disease development. Here, we review the association of different viruses to MS with an emphasis on two herpesviruses, Epstein-Barr virus (EBV) and human herpesvirus 6 (HHV-6). These two agents have generated the most impact during recent years as possible co-factors in MS disease development. The strongest argument for association of EBV with MS comes from the link between symptomatic infectious mononucleosis and MS and from seroepidemiological studies. In contrast to EBV, HHV-6 has been found significantly more often in MS plaques than in MS normal appearing white matter or non-MS brains and HHV-6 re-activation has been reported during MS clinical relapses. In this review we also suggest new strategies, including the development of new infectious animal models of MS and antiviral MS clinical trials, to elucidate roles of different viruses in the pathogenesis of this disease. Furthermore, we introduce the idea of using unbiased sequence-independent pathogen discovery methodologies, such as next generation sequencing, to study MS brain tissue or body fluids for detection of known viral sequences or potential novel viral agents.
authors.affiliation: Viral Immunology Section, Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
authors.forename: Jussi Oskari
authors.initials: JO
authors.lastname: Virtanen
authors.forename: Steve
authors.initials: S
authors.lastname: Jacobson
mesh_terms: D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use; D015551:Autoimmunity; D004195:Disease Models, Animal; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000187:drug effects / Q000472:pathogenicity / Q000502:physiology*; D015654:Herpesvirus 6, Human / Q000187:drug effects / Q000276:immunology / Q000472:pathogenicity* / Q000502:physiology; D006801:Humans; D007244:Infectious Mononucleosis / Q000276:immunology / Q000503:physiopathology / Q000821:virology; D018716:Molecular Mimicry; D009103:Multiple Sclerosis / Q000209:etiology / Q000276:immunology / Q000517:prevention & control / Q000821:virology*; D012307:Risk Factors; D019349:Roseolovirus Infections / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D055502:Secondary Prevention; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000998:Antiviral Agents