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==Overview==
==Overview==
Common causes of multiple sclerosis include: [[Autoimmunity]], [[genetic]], [[infectious]] and [[Degeneration (medical)|degeneration]].
Multiple sclerosis may be caused by different categories of causes include: [[Autoimmunity]], [[genetic]], [[infectious]] and [[Degeneration (medical)|degeneration]].


== Causes ==
== Causes ==


Multiple sclerosis may be caused by:
=== Common Causes ===
 
Common [[causes]] of multiple sclerosis may include:
==== Autoimmunity: ====
* '''Autoimmunity:'''
The main [[hypothesis]] regarding [[MS]] [[etiology]] is that it is caused by an [[autoimmune reaction]] against [[central nervous system]] ([[CNS]]).<ref name="pmid18970977">{{cite journal |vauthors=Compston A, Coles A |title=Multiple sclerosis |journal=Lancet |volume=372 |issue=9648 |pages=1502–17 |year=2008 |pmid=18970977 |doi=10.1016/S0140-6736(08)61620-7 |url=}}</ref> Self reactive [[T cell|T cells]] which has been activated by a foreign ([[virus]] for example) or native factor, will attack the [[myelin sheath]] around the [[neurons]].<ref name="pmid19300953">{{cite journal |vauthors=Korn T |title=Pathophysiology of multiple sclerosis |journal=J. Neurol. |volume=255 Suppl 6 |issue= |pages=2–6 |year=2008 |pmid=19300953 |doi=10.1007/s00415-008-6001-2 |url=}}</ref> Presents of autoreactive [[T cell|T cells]] and myelin basic protein-specific [[CD4+ T cells]] in the [[peripheral blood smear]] of [[MS]] [[Patient|patients]] supports the [[Autoimmunity|autoimmune]] [[hypothesis]].<ref name="pmid1700336">{{cite journal |vauthors=Pette M, Fujita K, Kitze B, Whitaker JN, Albert E, Kappos L, Wekerle H |title=Myelin basic protein-specific T lymphocyte lines from MS patients and healthy individuals |journal=Neurology |volume=40 |issue=11 |pages=1770–6 |year=1990 |pmid=1700336 |doi= |url=}}</ref> <ref name="pmid11017150">{{cite journal |vauthors=Bielekova B, Goodwin B, Richert N, Cortese I, Kondo T, Afshar G, Gran B, Eaton J, Antel J, Frank JA, McFarland HF, Martin R |title=Encephalitogenic potential of the myelin basic protein peptide (amino acids 83-99) in multiple sclerosis: results of a phase II clinical trial with an altered peptide ligand |journal=Nat. Med. |volume=6 |issue=10 |pages=1167–75 |year=2000 |pmid=11017150 |doi=10.1038/80516 |url=}}</ref>
** The primary [[hypothesis]] regarding [[MS]] [[etiology]] states that it is caused by an [[autoimmune reaction]] against the [[central nervous system]] ([[CNS]]).<ref name="pmid18970977">{{cite journal |vauthors=Compston A, Coles A |title=Multiple sclerosis |journal=Lancet |volume=372 |issue=9648 |pages=1502–17 |year=2008 |pmid=18970977 |doi=10.1016/S0140-6736(08)61620-7 |url=}}</ref>
 
** Self reactive [[T cell|T cells]] which has been activated by a foreign (such as [[virus]]) or native factor will attack the [[myelin sheath]] around the [[neurons]].<ref name="pmid19300953">{{cite journal |vauthors=Korn T |title=Pathophysiology of multiple sclerosis |journal=J. Neurol. |volume=255 Suppl 6 |issue= |pages=2–6 |year=2008 |pmid=19300953 |doi=10.1007/s00415-008-6001-2 |url=}}</ref>
==== Genetic: ====
** Presence of autoreactive [[T cell|T cells]] and [[myelin basic protein]]-specific [[CD4+ T cells]] in the [[peripheral blood smear]] of [[MS]] [[Patient|patients]] supports the [[Autoimmunity|autoimmune]] [[hypothesis]].<ref name="pmid1700336">{{cite journal |vauthors=Pette M, Fujita K, Kitze B, Whitaker JN, Albert E, Kappos L, Wekerle H |title=Myelin basic protein-specific T lymphocyte lines from MS patients and healthy individuals |journal=Neurology |volume=40 |issue=11 |pages=1770–6 |year=1990 |pmid=1700336 |doi= |url=}}</ref><ref name="pmid11017150">{{cite journal |vauthors=Bielekova B, Goodwin B, Richert N, Cortese I, Kondo T, Afshar G, Gran B, Eaton J, Antel J, Frank JA, McFarland HF, Martin R |title=Encephalitogenic potential of the myelin basic protein peptide (amino acids 83-99) in multiple sclerosis: results of a phase II clinical trial with an altered peptide ligand |journal=Nat. Med. |volume=6 |issue=10 |pages=1167–75 |year=2000 |pmid=11017150 |doi=10.1038/80516 |url=}}</ref>
There is some evidence proving [[genetic]] involvement in onset of [[MS]] so that it increases the risk of developing [[MS]] from 0.1 % in general population to 3% in those who have siblings with [[MS]] and 25% in those with a monozygote [[twin]] affected.<ref name="pmid12127654">{{cite journal |vauthors=Dessa Sadovnick A |title=The genetics of multiple sclerosis |journal=Clin Neurol Neurosurg |volume=104 |issue=3 |pages=199–202 |year=2002 |pmid=12127654 |doi= |url=}}</ref> HLA alleles seems to have a huge relationship with MS susceptibility.<ref name="pmid21541245">{{cite journal |vauthors=Ramagopalan SV, Dyment DA |title=What is Next for the Genetics of Multiple Sclerosis? |journal=Autoimmune Dis |volume=2011 |issue= |pages=519450 |year=2011 |pmid=21541245 |pmc=3085300 |doi=10.4061/2011/519450 |url=}}</ref>
 
==== Infectious: ====
 
==== Degeneration: ====


* '''Infectious:'''
** Infections including [[Epstein-Barr virus]], [[chlamydia]], and [[herpes virus]] seems to have some relations to [[MS]] based on finding pathogenic proteins and [[nucleic acids]] in [[post mortem]] [[patients]].<ref name="pmid9484408">{{cite journal |vauthors=Sriram S, Mitchell W, Stratton C |title=Multiple sclerosis associated with Chlamydia pneumoniae infection of the CNS |journal=Neurology |volume=50 |issue=2 |pages=571–2 |year=1998 |pmid=9484408 |doi= |url=}}</ref><ref name="pmid11450311">{{cite journal |vauthors=Soldan SS, Jacobson S |title=Role of viruses in etiology and pathogenesis of multiple sclerosis |journal=Adv. Virus Res. |volume=56 |issue= |pages=517–55 |year=2001 |pmid=11450311 |doi= |url=}}</ref><ref name="pmid25740864">{{cite journal |vauthors=Mechelli R, Manzari C, Policano C, Annese A, Picardi E, Umeton R, Fornasiero A, D'Erchia AM, Buscarinu MC, Agliardi C, Annibali V, Serafini B, Rosicarelli B, Romano S, Angelini DF, Ricigliano VA, Buttari F, Battistini L, Centonze D, Guerini FR, D'Alfonso S, Pesole G, Salvetti M, Ristori G |title=Epstein-Barr virus genetic variants are associated with multiple sclerosis |journal=Neurology |volume=84 |issue=13 |pages=1362–8 |year=2015 |pmid=25740864 |pmc=4388746 |doi=10.1212/WNL.0000000000001420 |url=}}</ref>


* '''Degeneration:'''
** In a progressive form of [[MS]], [[Axon|axonal]] degeneration and cortical [[atrophy]] are more prominent rather than contrast- enhancing lesions.<ref name="pmid24638138">{{cite journal |vauthors=Friese MA, Schattling B, Fugger L |title=Mechanisms of neurodegeneration and axonal dysfunction in multiple sclerosis |journal=Nat Rev Neurol |volume=10 |issue=4 |pages=225–38 |year=2014 |pmid=24638138 |doi=10.1038/nrneurol.2014.37 |url=}}</ref>
** Therefore, degeneration is suggested as an independent cause in [[pathology]] of multiple sclerosis.<ref name="pmid16230320">{{cite journal |vauthors=Kutzelnigg A, Lucchinetti CF, Stadelmann C, Brück W, Rauschka H, Bergmann M, Schmidbauer M, Parisi JE, Lassmann H |title=Cortical demyelination and diffuse white matter injury in multiple sclerosis |journal=Brain |volume=128 |issue=Pt 11 |pages=2705–12 |year=2005 |pmid=16230320 |doi=10.1093/brain/awh641 |url=}}</ref>


==References==
==References==
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[[Category:Primary care]]
[[Category:Neurology]]
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Latest revision as of 22:47, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Multiple sclerosis may be caused by different categories of causes include: Autoimmunity, genetic, infectious and degeneration.

Causes

Common Causes

Common causes of multiple sclerosis may include:

  • Degeneration:
    • In a progressive form of MS, axonal degeneration and cortical atrophy are more prominent rather than contrast- enhancing lesions.[8]
    • Therefore, degeneration is suggested as an independent cause in pathology of multiple sclerosis.[9]

References

  1. ↑ Compston A, Coles A (2008). "Multiple sclerosis". Lancet. 372 (9648): 1502–17. doi:10.1016/S0140-6736(08)61620-7. PMID 18970977.
  2. ↑ Korn T (2008). "Pathophysiology of multiple sclerosis". J. Neurol. 255 Suppl 6: 2–6. doi:10.1007/s00415-008-6001-2. PMID 19300953.
  3. ↑ Pette M, Fujita K, Kitze B, Whitaker JN, Albert E, Kappos L, Wekerle H (1990). "Myelin basic protein-specific T lymphocyte lines from MS patients and healthy individuals". Neurology. 40 (11): 1770–6. PMID 1700336.
  4. ↑ Bielekova B, Goodwin B, Richert N, Cortese I, Kondo T, Afshar G, Gran B, Eaton J, Antel J, Frank JA, McFarland HF, Martin R (2000). "Encephalitogenic potential of the myelin basic protein peptide (amino acids 83-99) in multiple sclerosis: results of a phase II clinical trial with an altered peptide ligand". Nat. Med. 6 (10): 1167–75. doi:10.1038/80516. PMID 11017150.
  5. ↑ Sriram S, Mitchell W, Stratton C (1998). "Multiple sclerosis associated with Chlamydia pneumoniae infection of the CNS". Neurology. 50 (2): 571–2. PMID 9484408.
  6. ↑ Soldan SS, Jacobson S (2001). "Role of viruses in etiology and pathogenesis of multiple sclerosis". Adv. Virus Res. 56: 517–55. PMID 11450311.
  7. ↑ Mechelli R, Manzari C, Policano C, Annese A, Picardi E, Umeton R, Fornasiero A, D'Erchia AM, Buscarinu MC, Agliardi C, Annibali V, Serafini B, Rosicarelli B, Romano S, Angelini DF, Ricigliano VA, Buttari F, Battistini L, Centonze D, Guerini FR, D'Alfonso S, Pesole G, Salvetti M, Ristori G (2015). "Epstein-Barr virus genetic variants are associated with multiple sclerosis". Neurology. 84 (13): 1362–8. doi:10.1212/WNL.0000000000001420. PMC 4388746. PMID 25740864.
  8. ↑ Friese MA, Schattling B, Fugger L (2014). "Mechanisms of neurodegeneration and axonal dysfunction in multiple sclerosis". Nat Rev Neurol. 10 (4): 225–38. doi:10.1038/nrneurol.2014.37. PMID 24638138.
  9. ↑ Kutzelnigg A, Lucchinetti CF, Stadelmann C, Brück W, Rauschka H, Bergmann M, Schmidbauer M, Parisi JE, Lassmann H (2005). "Cortical demyelination and diffuse white matter injury in multiple sclerosis". Brain. 128 (Pt 11): 2705–12. doi:10.1093/brain/awh641. PMID 16230320.

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