Department of Neurology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100, Larissa, Greece.
B' Department of Neurology, Multiple Sclerosis Center, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636, Thessaloniki, Greece.
Rev Neurosci. 2022 Mar 7;33(7):703-720. doi: 10.1515/revneuro-2021-0148. Print 2022 Oct 26.
The purpose of this review is to examine whether there is a possible (etiological/triggering) relationship between infection with various Coronaviruses, including Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV-2), the virus responsible for the Coronavirus disease-19 (Covid-19) pandemia, and Multiple Sclerosis (MS), and whether an increase of the prevalence of MS after the current Covid-19 pandemia should be expected, examining new and preexisting data. Although the exact pathogenesis of MS remains unknown, environmental agents seem to greatly influence the onset of the disease, with viruses being the most popular candidate. Existing data support this possible etiological relationship between viruses and MS, and experimental studies show that Coronaviruses can actually induce an MS-like demyelinating disease in animal models. Findings in MS patients could also be compatible with this coronaviral MS hypothesis. More importantly, current data from the Covid-19 pandemia show that SARS-CoV-2 can trigger autoimmunity and possibly induce autoimmune diseases, in the Central Nervous System as well, strengthening the viral hypothesis of MS. If we accept that Coronaviruses can induce MS, it is reasonable to expect an increase in the prevalence of MS after the Covid-19 pandemia. This knowledge is of great importance in order to protect the aging groups that are more vulnerable against autoimmune diseases and MS specifically, and to establish proper vaccination and health policies.
本次综述的目的是探讨多种冠状病毒（包括引发严重急性呼吸系统综合征的冠状病毒-2（SARS-CoV-2），即导致新冠肺炎大流行的病毒）与多发性硬化症（MS）之间是否存在可能的（病因学/触发）关系，以及在当前新冠肺炎大流行之后，是否应该预期 MS 的患病率会增加，并对新的和已有的数据进行审查。虽然 MS 的确切发病机制仍不清楚，但环境因素似乎极大地影响了疾病的发生，其中病毒是最受欢迎的候选因素。现有数据支持病毒与 MS 之间存在这种可能的病因关系，实验研究表明冠状病毒实际上可以在动物模型中诱发类似于 MS 的脱髓鞘疾病。MS 患者的发现也与这种冠状病毒 MS 假说相符。更重要的是，目前来自新冠肺炎大流行的数据表明，SARS-CoV-2 可以引发自身免疫，并可能诱发中枢神经系统自身免疫性疾病，这进一步支持了 MS 的病毒假说。如果我们接受冠状病毒可以引发 MS，那么在新冠肺炎大流行之后，MS 的患病率增加是合理的预期。了解这一点对于保护易患自身免疫性疾病和 MS 的老年人群体尤为重要，并有助于制定适当的疫苗接种和卫生政策。
