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Journal of Neurology

, 256:1052

First Online: 01 March 2009Received: 06 January 2009Accepted: 09 February 2009


Multiple sclerosis MS with onset in childhood offers a unique opportunity to study the infectious background of this disease but the immune reactions against infectious agents in such children have only recently been investigated. These and other epidemiological studies strongly implicate involvement of one or more infectious agents in the aetiology of MS, with Epstein-Barr virus EBV being the prime candidate. Rather than being the actual cause of MS, it is more probable that these agents are involved in the development of immunoregulatory pathways. These pathways, if disturbed by hygiene-related factors including an altered sequence of infections, may generate and maintain a deficit within the immunological network that facilitates, to particular early events in the development of MS, preceding the onset of MS disease by years or a decade. A framework that can serve as a guide for further epidemiological, immunologic and molecular biologic investigations is formulated. This approach may shed light on the complex natural history of MS and may lead to rational preventive and therapeutic strategies. It is possible that, in the future, MS could be prevented by vaccination against EBV in early childhood; the framework is of relevance to the design of an appropriate type of vaccine.

KeywordsMultiple sclerosis Common infections Epstein-Barr virus Hygiene hypothesis Endogenous retroviruses Immunologic network  Download fulltext PDF

Autor: Bernd Krone - Frank Oeffner - John M. Grange


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