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Infection as an Environmental Trigger of Multiple Sclerosis Disease Exacerbation
1Department of Animal Sciences, College of Agricultural, Consumer and Environmental Sciences, University of Illinois Urbana-Champaign , Urbana, IL , USA ; Neuroscience Program, University of Illinois Urbana-Champaign , Urbana, IL , USA ; Division of Nutritional Sciences, University of Illinois Urbana-Champaign , Urbana, IL , USA.
Abstract:
Over the past several decades, significant advances have been made in identifying factors that contribute to the pathogenesis of multiple sclerosis (MS) and have culminated in the approval of some effective therapeutic strategies for disease intervention. However, the mechanisms by which environmental factors, such as infection, contribute to the pathogenesis and/or symptom exacerbation remain to be fully elucidated. Relapse frequency in MS patients contributes to neurological impairment and, in the initial phases of disease, serves as a predictor of poor disease prognosis. The purpose of this review is to examine the evidence that supports a role for peripheral infection in modulating the natural history of this disease. Evidence supporting a role for infection in promoting exacerbation in animal models of MS is also reviewed. Finally, a few mechanisms by which infection may exacerbate symptoms of MS and other neurological diseases are discussed. Those who comprise the majority of MS patients acquire approximately two upper-respiratory infections per year; furthermore, this type of infection doubles the risk for MS relapse, underscoring the contribution of this relationship as being potentially important and particularly detrimental.
Insights
Peripheral infections, like respiratory infections, can double the risk of multiple sclerosis (MS) relapses. Understanding how infections impact MS is crucial for managing the disease and improving patient outcomes.
Area of Science:
- Neuroimmunology
- Infectious Disease Epidemiology
Background:
- Multiple sclerosis (MS) pathogenesis research has identified key factors and led to effective therapies.
- Environmental factors, particularly infections, are suspected contributors to MS pathogenesis and symptom exacerbation, but mechanisms remain unclear.
Purpose of the Study:
- To review evidence linking peripheral infections to the natural history of multiple sclerosis (MS).
- To examine the role of infection in exacerbating MS in animal models.
- To discuss potential mechanisms by which infections may worsen MS and other neurological conditions.
Main Methods:
- Literature review of studies on peripheral infection and multiple sclerosis (MS).
- Analysis of evidence from animal models of MS concerning infection-induced exacerbation.
- Discussion of proposed biological mechanisms.
Main Results:
- Peripheral infections, such as upper-respiratory infections, are common in MS patients.
- Upper-respiratory infections are associated with a doubled risk of MS relapse.
- Evidence suggests infection can promote exacerbation in animal models of MS.
Conclusions:
- Peripheral infections play a significant role in modulating the course of multiple sclerosis (MS).
- Infections, especially respiratory infections, are detrimental and increase relapse risk in MS patients.
- Further research into infection-induced exacerbation mechanisms is warranted for improved MS management.
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