Abstract
A neurological surveillance was combined with prospective recording of upper respiratory and gastrointestinal infections and serological diagnosis of five common viral infections in 60 benign multiple sclerosis patients, with a mean follow-up of 31 months. During 4-week at risk (AR) periods encompassing common infections, a significant excess of MS relapses was found in the AR period, with a relative risk of 1.3. A seasonal variation of the MS relapse rate was found with a minimum in summer. There was a significant correlation between the number of AR relapses and the number of common infections per month explaining the periannual distribution of relapses. The non-AR relapses showed no seasonal variation. There was a significant correlation between adenovirus CF titre rises associated with upper respiratory infections and the occurrence of a major MS relapse in the AR period (n = 7), while influenza infections were not followed by a major MS relapse (n = 6). Linear homologies have been demonstrated between adenovirus and basic myelin protein. The epidemiological approach is essential to our understanding of systemic antigens triggering multiple sclerosis activity.
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References
Alvord EC Jr, Jahnke U, Fischer EH, et al (1987) The multiple causes of multiple sclerosis: the importance of age of infections in childhood. J Child Neurol 2:313–321
Andersen O (1980) Restricted dissemination of clinically defined attacks in an MS incidence material. Acta Neurol Scand 62 [Suppl 77] 18
Bernard C, Townsend E, Randell VB, Williamson HG (1983) Do antibodies to myelin basic protein isolated from multiple sclerosis cross-react with measles and other common virus antigens? Clin Exp Immunol 52:98–106
Dean G, Kurtzke JF (1971) On the risk of multiple sclerosis according to age at immigration to South Africa. BMJ 3:725–729
Ebers GC, Bulman DE, Sadovnick AD, et al (1986) A population-based study of multiple sclerosis in twins. N Engl J Med 315:1638–1642
Edwards JH (1961) The recognition and estimation of cyclic trends. Ann Hum Genet 25:83–87
Fujinami RS, Oldstone MB (1985) Amino acid homology between the encephalitogenic site of myelin basic protein and virus: mechanism for autoimmunity. Science 230:1043–1045
Gay D, Dick G, Upton G (1986) Multiple sclerosis associated with sinusitis: case-controlled study in general practice. Lancet 1:815–819
Gwaltney JM Jr (1985) Virology and immunology of the common cold. Rhinology 23:265–271
Hammond SR, McLeod JG, Millingen KS, et al (1988) The epidemiology of multiple sclerosis in three Australian cities: Perth, Newcastle and Hobart. Brain 111:1–25
Jahnke U, Fischer EH, Alvord EC Jr (1985) Sequence homology between certain viral proteins and proteins related to encephalomyelitis and neuritis. Science 229:282–284
Kurtzke JF (1970) Clinical manifestations of multiple sclerosis. In: Vinken PJ, Bruyn GW (ed) Handbook of clinical neurology, vol 9. North-Holland, Amsterdam, p 161
Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disabiliy status scale (EDSS) Neurology 33:1444–1452
Mårtensson E, Axelsson R, Oden A (1980) Prophylactic effect of continuous treatment with antidepressants. Curr Ther Res 28:767–776
Merck C, Angervall L, Kindblom LG, Odén A (1983) Myxofibrosarcoma. A malignant soft tissue tumor of fibroblastic-histiocytic origin. A clinicopathological and prognostic study of 110 cases using multivariate analysis. Acta Pathol Microbiol Immunol Scand [Suppl] 282:1–40
Norrby E, Veen J van der, Espmark A (1970) A new serological technique for identification of adenovirus infections. Proc Soc Exp Biol Med 134:889–895
Panitch HS, Bever T, Katz E, Johnson KP (1991) Upper respiratory tract infections trigger attacks of multiple sclerosis in patients treated with interferon. J Neuroimmunol [Suppl 1]:125
Poser CM, Paty DW, Scheinberg L, et al (1983) New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13:227–231
Salmi A, Reunanen M, Ilonen J, Panelius M (1983) Intrathecal antibody synthesis to virus antigens in multiple sclerosis. Clin Exp Immunol 52:241–249
Schapira K (1959) The seasonal incidence of onset and exacerbations in multiple sclerosis. J Neurol Neurosurg Psychiatry 22:285–286
Schauf CL, Davis FA (1974) Impulse conduction in multiple sclerosis: a theoretical basis for modification by temperature and pharmacological agents. J Neurol Neurosurg Psychiatry 37:152–161
Shaw SY, Laursen RA, Lees MB (1986) Analogous amino acid sequences in myelin proteolipid and viral proteins. FEBS Lett 207:266–270
Sibley WA, Foley JM (1965) Infection and immunization in multiple sclerosis. Ann NY Acad Sci 122:457–466
Sibley WA, Foley J (1965) Seasonal variation in multiple sclerosis and retrobulbar neuritis in Northeastern Ohio. Trans Am Neurol Assoc 90:295–297
Sibley WA, Bamford CR, Clark K (1985) Clinical viral infections and multiple sclerosis. Lancet I:1313–1315
Svenningsson A, Runmarker B, Lycke J, Andersen O (1990) Incidence of MS during two fifteen-year periods in the Gothenburg region of Sweden. Acta Neurol Scand 82:161–168
Vartdal F (1989) HLA associations in multiple sclerosis: implications for immunopathogenesis. Res Immunol 140:192–196
Weise MJ, Carnegie PR (1988) An approach to searching protein sequences for superfamily relationships or chance similarities relevant to the molecular mimicry hypothesis: application to the basic proteins of myelin. J Neurochem 51:1267–1273
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Andersen, O., Lygner, PE., Bergström, T. et al. Viral infections trigger multiple sclerosis relapses: a prospective seroepidemiological study. J Neurol 240, 417–422 (1993). https://doi.org/10.1007/BF00867354
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DOI: https://doi.org/10.1007/BF00867354