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Urinary tract infections may trigger relapse in multiple sclerosis

L M Metz1, S D McGuinness, C Harris

  • 1Multiple Sclerosis Clinic, Foothills Hospital, Calgary, AB.

Axone (Dartmouth, N.S.)
|December 16, 1998
PubMed
Summary
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Recurrent urinary tract infections (UTIs) in Multiple Sclerosis (MS) patients may trigger relapses and worsen neurological decline. This suggests infections could be a significant factor in MS progression, impacting treatment strategies.

Area of Science:

  • Neurology
  • Immunology
  • Infectious Diseases

Background:

  • Multiple Sclerosis (MS) is a leading cause of neurological disability in young adults.
  • Urinary tract dysfunction and infections are highly prevalent in the MS population.
  • Infections are increasingly recognized as potential triggers for MS exacerbations.

Observation:

  • Recurrent urinary tract infections (UTIs) were observed in three MS patients.
  • These UTIs coincided with acute MS exacerbations and neurological progression.
  • The progression was refractory to standard intravenous steroid treatments.

Findings:

  • Bacterial and viral infections can induce interferon release, activating immune pathways.
  • Interferon-gamma may precipitate MS relapses and stimulate tumor necrosis factor-alpha production.

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  • This cytokine is directly toxic to oligodendrocytes, crucial for myelin maintenance.

    • Implications:

    • Recurrent UTIs may be a modifiable factor contributing to MS exacerbation and progression.
    • Understanding infection-induced immune responses is critical for MS management.
    • This highlights the need for vigilance and prompt treatment of infections in MS patients.