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Autoimmun Rev. 2010 Mar;9(5):A387-94. doi: 10.1016/j.autrev.2009.11.010. Epub 2009 Nov 20.

Multiple sclerosis: geoepidemiology, genetics and the environment.

Author information

1
Department of Neurology, Barzilai Medical Center, Ashkelon, School of Health Sciences, Ben-Gurion University of the Negev, Israel. rmilo@barzi.health.gov.il

Abstract

Multiple sclerosis (MS) is a chronic immune-mediated demyelinating disease of the central nervous system characterized by relapses and remissions. The risk of acquiring this complex disease is associated with exposure to environmental factors in genetically susceptible individuals. The epidemiology of MS has been extensively studied. We review the geographic epidemiology of the disease, the influence of immigration, age at immigration, clustering and epidemics. Various presumptive risk factors are discussed such as ultraviolet radiation, vitamin D, Epstein-Barr virus and infectious mononucleosis, other infectious agents and non-infectious factors. Two different hypotheses, the hygiene hypothesis and the prevalence hypothesis, were proposed to explain these environmental risk factors for MS. The epidemiological data, combined with pathological and immunological data, may contribute to the debate whether MS is an autoimmune disease, a latent or persistent viral disease, or a neurodegenerative disease.

PMID:
19932200
DOI:
10.1016/j.autrev.2009.11.010
[Indexed for MEDLINE]

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