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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Viruses and multiple sclerosis
Jussi Oskari Virtanen1, Steve Jacobson
1Viral Immunology Section, Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
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.
Insights
Viruses, particularly Epstein-Barr virus (EBV) and human herpesvirus 6 (HHV-6), are increasingly implicated as environmental triggers in multiple sclerosis (MS) pathogenesis. Further research into viral roles and antiviral therapies is recommended.
Area of Science:
- Neuroimmunology
- Virology
- Genetics
Background:
- Multiple sclerosis (MS) is a complex neurological disease influenced by genetic and environmental factors.
- Viruses are suspected environmental triggers in MS pathogenesis, but specific causal agents remain unclear.
- Epstein-Barr virus (EBV) and human herpesvirus 6 (HHV-6) are key herpesviruses investigated for their role in MS.
Purpose of the Study:
- To review the association of various viruses with MS, focusing on EBV and HHV-6.
- To discuss the evidence linking EBV and HHV-6 to MS development.
- To propose novel strategies for investigating viral roles in MS pathogenesis.
Main Methods:
- Review of existing literature on viral associations with MS.
- Examination of seroepidemiological data and clinical observations linking EBV to MS.
- Analysis of viral presence in MS lesions and correlation with disease activity for HHV-6.
Main Results:
- Strong associations exist between EBV, infectious mononucleosis, and MS.
- HHV-6 is found more frequently in MS plaques compared to normal brain tissue.
- HHV-6 reactivation correlates with MS relapses.
Conclusions:
- Viruses, especially EBV and HHV-6, are significant potential co-factors in MS pathogenesis.
- Development of new animal models and antiviral clinical trials are crucial for further elucidation.
- Advanced sequencing techniques can aid in identifying known and novel viral agents in MS.
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