PMID- 26046559
DCOM- 20160104
LR  - 20150606
IS  - 1600-0404 (Electronic)
IS  - 0001-6314 (Linking)
VI  - 132
IP  - 199
DP  - 2015
TI  - Multiple sclerosis and environmental factors: the role of vitamin D, parasites,
      and Epstein-Barr virus infection.
PG  - 46-55
LID - 10.1111/ane.12431 [doi]
AB  - Pathogenic mechanisms underlying multiple sclerosis development have yet to be
      clearly identified, but considerable evidence indicates that autoimmunity plays
      an important role in the etiology of the disease. It is generally accepted that
      autoimmune diseases like MS arise from complex interactions between genetic
      susceptibility and environmental factors. Although environmental factors
      unequivocally influencing MS development have yet to be established, accumulating
      evidence singles out several candidates, including sunlight-UV exposure or
      vitamin D deficiency, viral infections, hygiene, and cigarette smoking. Vitamin D
      deficiency has been associated with different autoimmune diseases. Several
      investigations indicate 125 (OH)2 vitamin D plays a critical role in shaping
      T-cell response and inducing T cells with immunosuppressive properties. Likewise,
      helminth infections represent another potential environmental factor exerting
      immunomodulatory properties. Both epidemiological and experimental data provide
      evidence to support autoimmune down-regulation secondary to parasite infections
      in patients with MS, through regulatory T- and B-cell action, with effects
      extending beyond simple response to an infectious agent. Finally, different
      epidemiological studies have demonstrated that Epstein-Barr virus infection
      confers added risk of developing MS. Proposed mechanisms responsible for this
      association include activation and expansion of self-reactive T and B cells,
      lower threshold for self-tolerance breakdown, and enhanced autoreactive B-cell
      survival, all to be discussed in this review. Understanding environmental factors
      influencing propensity to MS will lead to new and more effective approaches to
      prevent and treat the disease.
CI  - (c) 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Correale, J
AU  - Correale J
AD  - Department of Neurology, Institute for Neurological Research Dr. Raul Carrea,
      FLENI, Buenos Aires, Argentina.
FAU - Gaitan, M I
AU  - Gaitan MI
AD  - Department of Neurology, Institute for Neurological Research Dr. Raul Carrea,
      FLENI, Buenos Aires, Argentina.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Denmark
TA  - Acta Neurol Scand
JT  - Acta neurologica Scandinavica
JID - 0370336
RN  - 1406-16-2 (Vitamin D)
SB  - IM
MH  - *Environment
MH  - Epstein-Barr Virus Infections/complications/*epidemiology
MH  - Helminthiasis/complications/epidemiology
MH  - Humans
MH  - Immune System
MH  - Multiple Sclerosis/*epidemiology
MH  - Nutritional Status
MH  - Parasitic Diseases/complications/*epidemiology
MH  - Vitamin D/*physiology
OT  - Epstein-Barr virus
OT  - environmental factors
OT  - helminth infections
OT  - hygiene hypothesis
OT  - multiple sclerosis
OT  - vitamin D
EDAT- 2015/06/06 06:00
MHDA- 2016/01/05 06:00
CRDT- 2015/06/06 06:00
PHST- 2015/04/10 00:00 [accepted]
PHST- 2015/06/06 06:00 [entrez]
PHST- 2015/06/06 06:00 [pubmed]
PHST- 2016/01/05 06:00 [medline]
AID - 10.1111/ane.12431 [doi]
PST - ppublish
SO  - Acta Neurol Scand. 2015;132(199):46-55. doi: 10.1111/ane.12431.