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Effects of infectious mononucleosis and HLA-DRB1*15 in multiple sclerosis

T R Nielsen1, K Rostgaard, J Askling

  • 1Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark. trn@ssi.dk

Multiple Sclerosis (Houndmills, Basingstoke, England)
|January 21, 2009
PubMed
Abstract

Insights

Human leukocyte antigen (HLA)-DRB1*15 and infectious mononucleosis (IM) significantly increase multiple sclerosis (MS) risk. Their combined effect shows a synergistic interaction, elevating risk substantially in individuals with both factors.

Area of Science:

  • Immunogenetics
  • Neuroimmunology
  • Epidemiology

Background:

  • Human leukocyte antigen (HLA)-DRB1*15 and Epstein-Barr virus (EBV) infection, presenting as infectious mononucleosis (IM), are established risk factors for multiple sclerosis (MS).
  • The potential combined effect and interaction between HLA-DRB1*15 and IM on MS risk remain largely unknown.

Purpose of the Study:

  • To investigate the association between HLA-DRB1*15 and the risk of developing MS.
  • To specifically assess this association in individuals with and without a history of IM.

Main Methods:

  • A comparative study design was employed, contrasting the prevalence of HLA-DRB1*15 in MS patients and blood donors.
  • Participants were stratified based on the presence or absence of a history of IM.
  • Relative MS risk associated with HLA-DRB1*15 was estimated in both IM-exposed and IM-naïve groups, and interaction was quantified using odds ratios.

Main Results:

  • In individuals without a history of IM, HLA-DRB1*15 conferred a 2.4-fold increased MS risk.
  • Among individuals with a history of IM, HLA-DRB1*15 was associated with a 7.0-fold increased MS risk.
  • The risk of MS associated with HLA-DRB1*15 was approximately 2.9-fold stronger in those with IM history compared to those without. Individuals positive for both HLA-DRB1*15 and IM history showed a 10.0-fold increased MS risk compared to double-negative individuals.

Conclusions:

  • The findings suggest a synergistic interaction between HLA-DRB1*15 and infectious mononucleosis in the etiology of multiple sclerosis.
  • These genetic and infectious factors may act in concert to significantly elevate an individual's susceptibility to MS.

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