Triggers in MSThursday, October 03, 2013, 14:15 - 14:35
Triggering role of viruses in multiple sclerosisJ. Gold, T. Christensen, H. Maruszak , G. Giovannoni (Sydney, AU; Aarhus, DK; London, GB)
The relationship between viral infections and the causation or triggering of all forms of multiple sclerosis remains unresolved, despite more than 50 years of intense laboratory based research. Although it is well accepted that viruses are somehow implicated in the pathogenesis of MS, there is little consensus as to which viruses are involved (except possibly Epstein-Barr virus), at what stage of the disease process they may exert their effect and do they act alone or in concert with other factors such as Vitamin D deficiency and genetic and environmental influences. While many currently used disease modifying therapies are purported to have anti-viral activity, there are almost no studies to directly attribute their efficacy to this possibility. This lack of data on the role of viruses in MS can be attributed to technical problems in isolating specific viruses from relevant tissue and the dearth of effective anti-viral drugs which could be tested in a clinical trial situation. Moreover, the focus of drug development remains almost exclusively on immune-modulation and life-long treatment rather than on identifying a possible viral etiology and potentially curative treatment for MS. This presentation will briefly review the currently available data on viruses as triggers for MS and the implications of current disease modifying therapies on the future of enhancing pathogenic viruses. The presentation will concentrate on considering new data on the overwhelmingly and universally negative epidemiological relationship between MS and patients who have Human Immunodeficiency Syndrome (HIV), despite these diseases affecting similar demographic populations. As an extension of this observation, the presentation will discuss the role of human retroviruses as a cause for MS and the possibility that in patients with HIV the use of effective anti-retroviral therapies has co-incidentally also treated those patients who should have developed multiple sclerosis.
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