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Does delay in acquiring childhood infection increase risk of multiple sclerosis?

The Italian Journal of Neurological Sciences volume 8, pages 23–28 (1987)Cite this article

Abstract

Multiple sclerosis (MS) appears to be more common in technically advanced countries than in underdeveloped regions and migration from one area to an-other at a young age affects the risk of acquiring MS. One way of explaining both the peculiar frequency distribution and the effect of migration while young is to postulate that an infection early in life decreases the chance of central demyelination. However, no specific infection has been implicated consistently. Alternatively, an aberrant host response to infection in childhood might induce central demyelination. Thus, the aberrant host response could be age-dependent. In seeking associations between age of infection and risk of MS, we observed a direct relationship: where childhood diseases were acquired early in life, the frequency of MS in that population was low; where childhood diseases tended to occur nearer adolescence, MS frequency in that population was high. Since immune responsiveness to antigenic challenges matures through early adolescence, we reason that early infection might be protective and delay in acquiring childhood infections might increase the risk of developing MS. Indeed, in experimental models, the chance of inducing chronic relapsing central demyelination is increased by using adolescent rather than newborn or mature animals. In this paper, epidemiologic evidence showing the strong association between age of infection and risk of MS is presented.

Sommario

La sclerosi a placche è più frequente nei paesi industrializzati che in quelli sottosviluppati, e la migrazione da un'area all'altra in età giovanile modifica il rischio di ammalare. Per spiegare la particolare distribuzione di frequenza della malattia e l'effetto della migrazione, è necessario postulare che un'infezione in età infantile diminuisca il rischio di malattia demielinizzante del sistema nervoso centrale; tuttavia nessuna infezione specifica è stata dimostrata con certezza.

Un'altra spiegazione potrebbe essere che la malattia demielinizzante è favorita da una risposta anormale a un'infezione contratta nella fanciullezza. La risposta anormale dell'ospite all'infezione potrebbe essere legata all'età. Valutando le possibilità di associazioni fra età di infezione e rischio di sclerosi a placche, abbiamo osservato una relazione diretta: nelle popolazioni in cui le malattie infettive erano contratte precocemente, la frequenza di sclerosi multipla era bassa, nelle popolazioni in cui le malattie infettive avevano una tendenza a manifestarsi verso l'adolescenza la frequenza di sclerosi multipla era elevata.

Siccome la risposta immunitaria alle sollecitazioni antigeniche matura nel corso della prima parte dell'adolescenza, si può ipotizzare che un'infezione precoce possa proteggere dalla sclerosi a placche, mentre un ritardo nel contrarre le malattie infettive dell'infanzia può aumentare il rischio di sviluppare la sclerosi a placche. Nell'animale da esperimento, la possibilità di indurre una malattia demielinizzante ricorrente e cronica del sistema nervoso centrale è favorita dall'uso di animali giovani, mentre si riduce utilizzando animali neonati o animali adulti.

Questo lavoro illustra le prove epidemiologiche dell'associazione fra età di infezione e rischio di sclerosi a placche.

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Authors and Affiliations

  1. Neuroepidemiology Section, Department of Neurology, Temple University Medical School, 3401 North Braod Street, 19140, Philadelphia, PA

    Alter M., Zhen-xin Z., Davanipour Z., Sobel E., Min Lai S. & LaRue L.

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  1. Alter M.
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  2. Zhen-xin Z.
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  3. Davanipour Z.
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Alter, M., Zhen-xin, Z., Davanipour, Z. et al. Does delay in acquiring childhood infection increase risk of multiple sclerosis?. Ital J Neuro Sci 8, 23–28 (1987). https://doi.org/10.1007/BF02361431

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Key-Words

  • Multiple sclerosis
  • infection
  • immune response
  • age
  • epidemiology