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Reducing infection risk in multiple sclerosis and neuromyelitis optica spectrum disorders: a Brazilian reference
Ana Beatriz Ayroza Galvão Ribeiro Gomes1, Lucas Bueno Feo1, Guilherme Diogo Silva1
1Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Neurologia,, São Paulo SP, Brazil.
Background:
Multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) are the most common autoimmune diseases of the central nervous system (CNS). They present chronic relapsing courses that demand treatment with disease-modifying drugs (DMDs) to prevent inflammatory activity. Disease-modifying drugs lead to immunomodulation or immunosuppression through diverse mechanisms (e.g., shifting lymphocyte and cytokine profile, suppressing specific lymphocyte subpopulations). Thus, patients are more prone to infectious complications and associated worsening of disease.
Objective:
To present feasible strategies for mitigating the infection risk of MS and NMOSD treated patients.
Methods:
Targeted literature review concerning the management of infection risk with an emphasis on vaccination, therapy-specific measures, and particularities of the Brazilian endemic infectious diseases' scenario.
Conclusion:
We propose a vaccination schedule, infectious screening routine, and prophylactic measures based on the current scientific evidence. Awareness of emergent tropical diseases is necessary due to evidence of demyelinating events and possible parainfectious cases of MS and NMOSD.
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