Multiple sclerosis: risk factors, prodromes, and potential causal pathways (original) (raw)

Exogeneous factors in the aetiology of multiple sclerosis

Journal of neurovirology, 2000

Neuroepidemiology has undoubtedly played a fundamental role in the study of multiple sclerosis (MS) by providing some aetiologic clues, although a definitive basis for the conclusive resolution of its enigma is still lacking. Epidemiological and genetic studies have indicated that MS is probably caused by multiple factors, both genetic and environmental, none of which is individually sufficient, which appear to act before adolescence - or possibly later - in genetically susceptible individuals. This unifying hypothesis emphasizes, on the one hand, the role of a genetic-racial susceptibility and the importance of environmental factors and, on the other, a possible aetiologic heterogeneity and lack of specificity of the unknown endogenous and exogeneous agents. In this context, several environmental factors may be involved in the aetiopathogenesis of MS in individuals who are susceptible to the effect of exposure to these factors. Situations or events with biological plausibility, suc...

Multiple sclerosis genetics--is the glass half full, or half empty?

Nature reviews. Neurology, 2010

Multiple sclerosis (MS) is a common and severe CNS disorder that is characterized by myelin loss, chronic inflammation, axonal and oligodendrocyte pathology, and progressive neurological dysfunction. Extensive epidemiological data confirm that genetic variation is an important determinant of susceptibility to MS, and suggest that such variation also influences the timing of symptom onset, the course of the disease, and the treatment response. Multicenter international collaborations have allowed large and well-characterized sample collections to be assembled that, when coupled with high-powered laboratory technologies, afford the opportunity to analyze the genome with increasing resolution and detail. The seven MS genome-wide association screens that have been completed in the past 3 years have substantially lengthened the list of MS genetic risk associations. Nevertheless, our knowledge of MS genetics remains incomplete, with many risk alleles still to be revealed, although progres...