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Infection and the etiology and pathogenesis of multiple sclerosis

I Steiner1, P Nisipianu, I Wirguin

  • 1Department of Neurology, Hadassah University Hospital, PO Box 12000, Jerusalem 91120, Israel.

Current Neurology and Neuroscience Reports
|March 20, 2002
PubMed

Insights

Multiple sclerosis (MS) may be caused by infections, not autoimmunity. Research reviews evidence for infectious agents in MS etiology and pathogenesis, challenging current understanding.

Area of Science:

  • Neuroimmunology
  • Infectious Diseases
  • Neurology

Background:

  • Multiple sclerosis (MS) lacks a clear definition and its prognosis is unchanged by research.
  • The current view of MS as immune-mediated is questioned as it doesn't meet autoimmune disease criteria.
  • Significant data suggests infectious agents may directly damage white matter or cause secondary brain inflammation.

Purpose of the Study:

  • To review evidence supporting a critical role for infection in MS.
  • To examine potential infectious candidates implicated in MS.
  • To outline an approach for investigating the role of infectious agents in MS etiology and pathogenesis.

Main Methods:

  • Literature review of studies on MS and infectious agents.
  • Analysis of data supporting infectious involvement in MS pathogenesis.
  • Examination of proposed infectious agents in MS.

Main Results:

  • The prevailing immune-mediated theory of MS is challenged by lack of autoimmune criteria.
  • Evidence suggests infectious agents could be responsible for direct neurological damage or inflammation.
  • Several candidate infectious agents have been proposed in relation to MS.

Conclusions:

  • Infectious agents represent a plausible etiological factor in multiple sclerosis.
  • Rethinking MS as potentially infection-driven is warranted.
  • Further research is needed to identify specific infectious agents and their role in MS.

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