Multiple sclerosis causes

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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

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

## Causes

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### Common Causes

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Common causes of multiple sclerosis may include:

* Autoimmunity:
* The primary hypothesis regarding MS etiology states that it is caused by an autoimmune reaction against the central nervous system (CNS).[1]
* Self reactive T cells which has been activated by a foreign (such as virus) or native factor will attack the myelin sheath around the neurons.[2]
* Presence of autoreactive T cells and myelin basic protein-specific CD4+ T cells in the peripheral blood smear of MS patients supports the autoimmune hypothesis.[3][4]

* 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.[5][6][7]

* 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

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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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