Robert M Herndon
Mississippi State University, USA
Posters & Accepted Abstracts: J Neurol Neurosci
Despite an extensive search for viruses related to multiple sclerosis (MS) and the isolation of multiple agents from MS brain specimens, none have been clearly tied back to the disease as causative agents. It is clear that Epstein-Barr virus (EBV) is important in its pathogenesis but it does not appear to be, in and of itself, causative. It has been shown that some of the oligoclonal bands seen in the spinal fluid are directed against EBV antigens but the evidence of the presence of the virus in the lesions is controversial and the best evidence seems to indicate that it is not present in the nervous system. Herpes VI has been found in some MS lesions and may play a role in some cases. Anti-herpes drugs appear to be helpful based on some phase II trials data but no real phase III trials have been done and the phase II trials were too small to clearly establish the benefit though there was a strong trend that suggested a larger trial was warranted. Additionally, there is good evidence that epitope spreading is an important factor in disease activity.
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