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New Lancet Study: Infectious causes of MS

Posted: Sat Mar 19, 2005 4:22 pm
by Arron
And another...

Lancet Neurol. 2005 Mar;4(3):195-202. Related Articles, Links


Infectious causes of multiple sclerosis.

Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver, CO 80262, USA. don.gilden@uchsc.edu <don.gilden@uchsc.edu>

Multiple sclerosis (MS) is a serious chronic neurological disorder in which demyelination and inflammation occur in the white matter of the CNS. The findings of many epidemiological studies and a discordance of MS in monozygotic twins suggest that the disorder is acquired. The most likely cause is a virus because more than 90% of patients with MS have high concentrations of IgG, manifest as oligoclonal bands, in the brain and CSF. Most chronic inflammatory CNS disorders are infectious. More indirect evidence that MS is caused by a virus is the association of several viruses with demyelinating encephalomyelitis in human beings, and the induction of demyelination in animals infected with viruses in research. Nevertheless, no virus has been isolated from the brains of patients who had MS. Molecular analysis of IgG gene specificity in the brain and CSF of those with MS has shown features of an antigen-driven response: clonal amplification and extensive somatic mutations. A viral antigen against which the IgG in MS brain and CSF is directed might be identified.

Publication Types:
Review
Review, Tutorial

PMID: 15721830 [PubMed - indexed for MEDLINE]

Posted: Sun Mar 20, 2005 6:28 am
by SarahLonglands
Arron,
Both this study in the Lancet and the German one below are rather old now, in concept at least:
Interesting new study proposing a dual MS autoimmune/infection pathogenesis...

Fortschr Neurol Psychiatr. 2005 Marz;73(3):143-149. Related Articles, Links
[Differential Influence of Immune Therapy on Relapses and Progression in Multiple Sclerosis: Interpretation and Therapeutic Consequences.]
Kornhuber ME, Presek P, Zierz S.
Klinik fur Neurologie der Martin-Luther-Universitat Halle-Wittenberg (Direktor Prof. Dr. S. Zierz). malte.kornhuber@medizin.uni-halle.de.
It is well established that relapses can be suppressed by different substances in patients with relapsing-remitting multiple sclerosis (MS). In contrast, patients with progressive forms of MS do hardly respond to immune therapy. Therefore, start of immune therapy after the first relapse has been proposed, especially in order to prevent degeneration and disability. This view is challenged in the present review. Actually no evidence exists in support of a retardation or an attenuation of secondary progression by early immune therapy. Widespread degeneration occurs early and progresses independently from inflammatory plaques. Therefore, autoimmunity per se is no adequate paradigm to explain MS-pathogenesis entirely. A virus/superantigen-dualism is proposed to explain the different parts of MS, instead. It is concluded that evidence-based immune therapy should be adapted to the actual inflammatory activity of the disease. A suitable parameter for this purpose is the interval between 2 relapses.
However, it is rather fortuitous that you have just posted them because they coincided with a conversation in the Newsagents this morning between David and the consultant radiologist, who had just heard back from the neuro-radiologist at Addenbrooke's, who on reviewing my MRI scans commented that she had never seen anything like it in established progressive disease, only, sometimes in very early RRMS. We are talking here not only about the reduction of lesions but the rate of reduction of brain mass reducing to that of a normal 8O (?) person. To me, it just seems more and more that only actual microbiologists can see that the infective root of MS is not a virus. Viruses can follow along behind and to a certain extent confuse the matter, but no-one's MS has ever improved to almost non-existence by treating it as a viral infection.

Sarah
.

Posted: Sun Mar 20, 2005 11:33 am
by Arron
that is incredible news, Sarah, not just for the concept but the fact that you are (touch wood!) doing so much better. Made my day :) Thank you for sharing.

-a