Related Experiment Video
Updated: Jul 25, 2025
Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
Published on: September 12, 2016
The Role of Microorganisms in the Etiopathogenesis of Demyelinating Diseases
Jessica Frau1, Giancarlo Coghe1, Lorena Lorefice1
1Multiple Sclerosis Centre, ASL Cagliari, 09126 Cagliari, Italy.
Abstract:
Multiple sclerosis (MS), neuromyelitis optica (NMO) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD) are inflammatory diseases of the central nervous system (CNS) with a multifactorial aetiology. Environmental factors are important for their development and microorganisms could play a determining role. They can directly damage the CNS, but their interaction with the immune system is even more important. The possible mechanisms involved include molecular mimicry, epitope spreading, bystander activation and the dual cell receptor theory. The role of Epstein-Barr virus (EBV) in MS has been definitely established, since being seropositive is a necessary condition for the onset of MS. EBV interacts with genetic and environmental factors, such as low levels of vitamin D and human endogenous retrovirus (HERV), another microorganism implicated in the disease. Many cases of onset or exacerbation of neuromyelitis optica spectrum disorder (NMOSD) have been described after infection with Mycobacterium tuberculosis, EBV and human immunodeficiency virus; however, no definite association with a virus has been found. A possible role has been suggested for Helicobacter pylori, in particular in individuals with aquaporin 4 antibodies. The onset of MOGAD could occur after an infection, mainly in the monophasic course of the disease. A role for the HERV in MOGAD has been hypothesized. In this review, we examined the current understanding of the involvement of infectious factors in MS, NMO and MOGAD. Our objective was to elucidate the roles of each microorganism in initiating the diseases and influencing their clinical progression. We aimed to discuss both the infectious factors that have a well-established role and those that have yielded conflicting results across various studies.
Insights
Microorganisms are implicated in central nervous system inflammatory diseases like multiple sclerosis (MS), neuromyelitis optica (NMO), and MOG antibody disease (MOGAD). This review explores infectious factors, including Epstein-Barr virus (EBV), in disease initiation and progression.
Area of Science:
- Neuroimmunology
- Infectious Diseases
- Central Nervous System (CNS) Inflammatory Disorders
Background:
- Multiple sclerosis (MS), neuromyelitis optica (NMO), and MOG antibody disease (MOGAD) are inflammatory CNS diseases with multifactorial origins.
- Environmental factors, particularly microorganisms, are crucial in disease development, acting directly or via immune system interactions.
- Mechanisms like molecular mimicry, epitope spreading, bystander activation, and dual cell receptor theory are involved in pathogen-induced neuroinflammation.
Purpose of the Study:
- To review the current understanding of infectious factors in MS, NMO, and MOGAD.
- To elucidate the role of specific microorganisms in initiating these diseases and influencing their clinical progression.
- To discuss established and controversial infectious agents in the context of these neuroinflammatory conditions.
Main Methods:
- Literature review of studies investigating infectious agents and their association with MS, NMO, and MOGAD.
- Analysis of proposed mechanisms of microbial involvement, including molecular mimicry and immune activation.
- Synthesis of evidence regarding specific pathogens such as Epstein-Barr virus (EBV), Mycobacterium tuberculosis, human immunodeficiency virus (HIV), and Helicobacter pylori.
Main Results:
- Epstein-Barr virus (EBV) has a definitively established role in MS, with seropositivity being a prerequisite for disease onset.
- Infections with Mycobacterium tuberculosis, EBV, and HIV have been linked to neuromyelitis optica spectrum disorder (NMOSD) onset or exacerbation, though definitive viral associations are lacking.
- A potential role for Helicobacter pylori is suggested in MOGAD, particularly in individuals with aquaporin-4 antibodies, and human endogenous retroviruses (HERVs) are hypothesized to be involved in MOGAD.
Conclusions:
- Infectious agents play a significant role in the etiology and progression of MS, NMO, and MOGAD.
- While EBV is a confirmed factor in MS, the roles of other microorganisms in NMO and MOGAD require further investigation.
- Understanding these microbial interactions is crucial for developing targeted therapies for these debilitating CNS inflammatory diseases.
More Related Videos
09:01Flow Cytometric Analysis of Lymphocyte Infiltration in Central Nervous System during Experimental Autoimmune Encephalomyelitis
Published on: November 17, 2020
04:53Isolation of Mouse Primary Microglia by Magnetic-Activated Cell Sorting in Animal Models of Demyelination
Published on: April 5, 2022
Related Concept Videos
01:29Microorganisms in Medicine and Therapeutics
01:28Fungal Phylum Microsporidia
01:31Defense Against Bacterial Pathogens
Phagocytes
Phagocytes are the frontline soldiers of the immune system. They include neutrophils and macrophages. Neutrophils are the most abundant type of white blood cell and are quickly mobilized to the site of infection. Macrophages are larger cells that patrol...