Infections and relapses

[bromley]

Infection may raise MS relapse risk

Results of a study of adults with relapsing remitting multiple sclerosis point to a significant association between viral and bacterial infections and increased risk of relapse.

Investigators, in a report in the journal Neurology, note that published epidemiologic environmental observations point to infection as a possible causative factor or trigger in the onset of MS.

"Microorganisms induce strong immune responses specific for their own antigens, but microbial infections can also trigger responses against self-antigens, promoting inflammatory responses," they point out.

"Since no single microorganism has been identified as a clear etiologic agent in MS, a more likely explanation for the epidemiologic environmental observations is that infections introduce a proinflammatory bias in immune responsiveness in MS patients that is capable of triggering disease activity and exacerbations."

Dr. Jorge Correale from Raul Carrea Institute for Neurological Research in Buenos Aires, Argentina, and colleagues say their study supports this line of thinking.

The researchers followed 60 MS patients who were instructed to report as soon as they experienced symptoms of an infection.

The team found a threefold increase in the rate of MS exacerbations during the "at-risk period" ranging from 2 weeks prior to 5 weeks after the onset of symptoms of infection, compared with time periods outside this window.

Any MS attack during the at-risk period was considered temporally related to the infection.

When a narrower "at-risk" time window was considered around infection (2 weeks prior to 2 weeks after symptom onset), the risk of MS exacerbation was elevated fourfold.

"Viral and bacterial infections were equally associated with exacerbations," Dr. Correale and colleagues note.

The researchers also observed a significant increase in disease activity on magnetic resonance imaging among 20 patients who underwent serial imaging studies, as well as increased T cell activation and proinflammatory cytokine concentrations during infection-related MS exacerbations.

Relapses temporally linked to systemic infection caused more severe and sustained deficit than exacerbations with onset outside the at risk window, the researchers also report.

SOURCE: Neurology, August 22, 2006.

[CureOrBust]

Investigators, in a report in the journal Neurology, note that published epidemiologic environmental observations point to infection as a possible causative factor or trigger in the onset of MS.

Ha! they could of asked me. I can ONLY remember 1 cause/trigger for a relapse of my MS, if i ignore the relapses specifically caused by flagyl pulses, as part of the ABX's regimine.

In ten years of symptoms, i can only remember relapses after a cold / flu. It suprises me when i hear of other peoples triggers of stress etc. My main treatment in a way, is to avoid infection at all cost, and hence a relapse.

Although, thinking about their statement about the high-risk time BEFORE an infection. Would this not just be attributed to being non-symptomatic to the infection? Otherwise the MS would have to have ESP to know when you are about to get an infection.

[scoobyjude]

Good point CureorBust. I think a relapse is only a risk once an infection takes hold. MS does not know that we are going to have an infection a week from now and waits to spring itself at the right time. It may be mysterious but I don't think it's a mindreader. I just got over (well not 100% yet) an exacerbation or pseudo-exacerbation from a nasty cold and I realized my leg was acting very stiff a few days before the cold actually hit me full-on. Didn't think too much about it until I looked back. The symptoms got better once my cold got better. It wasn't as bad as my normal relapses but it still stunk. I think the goal is to avoid colds or infections as much as possible and that should reduce any chance of relapse. Though I thought it was already common knowledge that colds and infections could trigger relapses. That was one of the first things my neuro told me. Maybe I didn't completely understand what the article was saying.