Delasnerie-Lauprêtre N, Alpérovitch A
1 INSERM-U. 169, Villejuif.
Rev Prat. 1991 Sep 15;41(20):1884-7.
Multiple sclerosis is unevenly distributed throughout the world. Its prevalence depends on latitude: it decreases in each hemisphere from pole to equator. France is situated in a high prevalence zone, with 40 cases for 100,000 inhabitants. The prevalence of multiple sclerosis is modulated by risk factors unrelated to latitude; genetic susceptibility factors (HLA, Gm), as well as environmental, occupational, nutritional and infectious (notably viral) factors have been identified, but no conclusion can be drawn concerning their role in the aetiology and pathogenesis of the disease. Among the hypotheses that could put an end to this deadlock, the heterogeneity of multiple sclerosis must seriously be considered, and it might serve as a basis for further epidemiological studies benefiting from recent technological developments such as molecular genetics and magnetic resonance imaging.
多发性硬化症在全球分布不均。其患病率取决于纬度:在每个半球,从极地到赤道患病率逐渐降低。法国位于高患病率地区,每10万居民中有40例患者。多发性硬化症的患病率受与纬度无关的风险因素调节;已确定了遗传易感性因素(人类白细胞抗原、免疫球蛋白同种异型)以及环境、职业、营养和感染(尤其是病毒)因素,但关于它们在该疾病病因学和发病机制中的作用尚无定论。在可能打破这一僵局的假设中,必须认真考虑多发性硬化症的异质性,它可能为受益于分子遗传学和磁共振成像等最新技术发展的进一步流行病学研究提供基础。