The Probable Infectious Origin of Multiple Sclerosis

Abstract

Multiple sclerosis (MS) is an immune inflammatory disease that causes demyelination of the white matter of the central nervous system. It is generally accepted that the etiology of MS is multifactorial and believed to be a complex interplay between genetic susceptibility, environmental factors, and infectious agents. While the exact cause of MS is still unknown, increasing evidence suggests that disease development is the result of interactions between genetically susceptible individuals and the environment that lead to immune dysregulation and CNS inflammation. Genetic factors are not sufficient on their own to cause MS, and environmental factors such as viral infections, smoking, and vitamin D deficiency also play important roles in disease development. Several pathogens have been implicated in the etiology of MS, including Epstein-Barr virus, human herpesvirus 6, varicella-zoster virus, cytomegalovirus, Helicobacter pylori, Chlamydia pneumoniae, and Borrelia burgdorferi. Although vastly different, viruses and bacteria can manipulate host gene expression, causing immune dysregulation, myelin destruction, and neuroinflammation. This review emphasizes the pathogenic triggers that should be considered in MS progression.

Keywords: Borrelia burgdorferi; Chlamydia pneumoniae; Epstein–Barr virus (EBV); Helicobacter pylori; cytomegalovirus; human herpesvirus 6; multiple sclerosis; neuroinflammation; varicella-zoster virus.

Figure 1

Risk factors for multiple sclerosis. Adapted from “Risk Factors of Dementia”, by BioRender.com. Accessed on 17 February 2023. Retrieved from https://app.biorender.com/biorender-templates.