Multiple Sclerosis: Planet Earth

Levin LI, Munger KL, Rubertone MV, Peck CA, Lennette ET, Spiegelman D, Ascherio A. · Division of Preventive Medicine, Walter Reed Army Institute of Research, Washington, DC, USA. · JAMA. · Pubmed #12672770 links to  free full text

Abstract: CONTEXT: Infection with Epstein-Barr virus (EBV) has been associated with an increased risk of multiple sclerosis (MS), but the temporal relationship remains unclear. OBJECTIVE: To determine whether antibodies to EBV are elevated before the onset of MS. DESIGN, SETTING, AND POPULATION: Nested case-control study conducted among more than 3 million US military personnel with blood samples collected between 1988 and 2000 and stored in the Department of Defense Serum Repository. Cases were identified as individuals granted temporary or permanent disability because of MS. For each case (n = 83), 2 controls matched by age, sex, race/ethnicity, and dates of blood sample collection were selected. MAIN OUTCOME MEASURES: Antibodies including IgA against EBV viral capsid antigen (VCA) and IgG against VCA, nuclear antigens (EBNA complex, EBNA-1, and EBNA-2), diffuse and restricted early antigens, and cytomegalovirus. RESULTS: The average time between blood collection and MS onset was 4 years. The strongest predictors of MS were serum levels of IgG antibodies to VCA or EBNA complex. The risk of MS increased monotonically with these antibody titers; relative risk (RR) in persons in the highest category of VCA (> or =2560) compared with those in the lowest (< or =160) was 19.7 (95% confidence interval [CI], 2.2-174; P for trend =.004). For EBNA complex titers, the RR for those in the highest category (> or =1280) was 33.9 (95% CI, 4.1-283; P for trend <.001) vs those in the lowest category (< or =40). Similarly strong positive associations between EBV antibodies and risk of MS were already present in samples collected 5 or more years before MS onset. No association was found between cytomegalovirus antibodies and MS. CONCLUSION: These results suggest a relationship between EBV infection and development of MS.

Mogenet I, Simiand-Erdociain E, Canonge JM, Pris J. · No affiliation provided · Ann Pharmacother. · Pubmed #12708958 No free full text.

This publication has no abstract.

Anonymous90114. · No affiliation provided · Ann Pharmacother. · Pubmed #14742821 No free full text.

This publication has no abstract.

Midgard R, Seland JH, Hovdal H, Celius EG, Eriksen K, Jensen D, Heger H, Mellgren SI, Wexler A, Beiske AG, Myhr KM. · Nevrologisk avdeling, Molde sjukehus, 6407 Molde. · Tidsskr Nor Laegeforen. · Pubmed #15742012 links to  free full text

Abstract: A national group of neurologists and ophthalmologists have evaluated guidelines and recommendations for diagnosis, treatment and follow up of optic neuritis based on clinical experience and a review of relevant literature. Optic neuritis is a common, well characterised condition that appears as an isolated syndrome or as a manifestation of multiple sclerosis. Several other diseases must be considered for a differential diagnosis. Corticosteroid treatment of optic neuritis has been investigated in a number of trials, which show that corticosteroid treatment speeds up the recovery of vision without affecting the final visual outcome. The diagnostic procedure and the treatment options have changed over the last few years. Some aspects of investigation, treatment and follow up are still controversial.

Ascherio A, Rubertone M, Spiegelman D, Levin L, Munger K, Peck C, Lennette E. · No affiliation provided · JAMA. · Pubmed #15914742 No free full text.

This publication has no abstract.