Chapter 6 : Viruses and Multiple Sclerosis

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Multiple sclerosis (MS) is a complex demyelinating disease of the central nervous system (CNS) affecting mostly young adults. A few viruses, including human herpesvirus 6 (HHV-6), are accumulating considerable and consistent support for a role in MS. The complexity and diversity of MS pathologic features in relation to the history of the disease have made the identification of a single pathogenic pathway unsuccessful and are now contributing to a new approach to the study of the disease pathogenesis. There has been a strong contribution to MS research by use of the murine experimental autoimmune encephalomyelitis (EAE) model and the demonstration of myelin-reactive T cells that has focused considerable attention on cellular immunity. Not only can viruses induce direct damage of the infected cells, but they can also trigger autoimmune reactions leading to demyelination. There are a number of demyelinating diseases following systemic infections with viruses such as mumps, varicella-zoster, influenza, and measles viruses, termed postinfectious encephalomyelitis (PIE). Other demyelinating diseases with well-defined viral etiologies are progressive multifocal leukoencephalopathy (PML), subacute sclerosing panencephalitis (SSPE), and human T-cell leukemia virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The study of this unique, multifaceted disorder represents a challenging opportunity not only to better define the disease itself, but also to understand how the CNS, which once was considered an immune privileged site, reacts to infections and how one or more viral agents can cause aberrant autoimmunity.

Citation: Donati D, Jacobson S. 2002. Viruses and Multiple Sclerosis, p 99-124. In Brogden K, Guthmiller J (ed), Polymicrobial Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555817947.ch6
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