Case report: a 28-year-old female student has noticed an increasing visual disturbance in one eye for the past three days. She has the feeling of looking through a frosted glass window. Soon she can recognize with the eye almost nothing more. First, she sees an ophthalmologist, who soon sends her on to a neurologist. After several examinations, the doctor suspects multiple sclerosis.
This or similar is how the disease story of multiple sclerosis sometimes begins. It is one of the most common neurological disorders in young adulthood.
Multiple sclerosis (MS, Latin multiplex = multiple; Greek skleros = hard) is a chronic inflammatory disease of the central nervous system. It can affect the brain, the spinal cord as well as the optic nerves. Many signs indicate that it is an autoimmune disease.
Our video also explains what multiple sclerosis is:
Causes: What leads to multiple sclerosis?
Despite intensive worldwide research, the cause of MS is not yet clearly understood. There is much to be said for a combination of favorable hereditary factors and environmental influences that lead to an erroneous reaction of the body's own immune system. Several factors may have to be present at the same time for the disease to occur.
Is multiple sclerosis hereditary?
MS is not a "classic hereditary disease", which is passed on from parent to child. The risk for children of a parent with MS to also get MS is slightly increased compared to the general population (approximately 2 percent vs. 0.1 percent). Thus there are indications that hereditary factors favor the development of MS. Thus, the disease is not evenly distributed across all population groups and countries, but occurs with varying frequency regionally and in different ethnic groups. In medical practice, about one in five people with MS report having blood relatives who also had or have multiple sclerosis. The genetic causes are unclear. Hereditary characteristics of white blood cells could play a role, for example.
Does sunlight have an influence?
Interest in solar radiation and MS developed from the finding that the risk of MS increases with higher latitude. Countries with high solar radiation, such as Africa and much of Asia, have fewer patients than areas further north and south. The greater the exposure to sunlight, the better the body is normally able to produce vitamin D. The less daylight people get, the less vitamin D the organism tends to produce.
Researchers ame that the course for a later MS is already set in childhood. Studies of emigrants from high MS risk areas to low MS risk areas have shown that the risk of developing MS correlates with age at emigration. If a person does not emigrate until adulthood, he or she retains the disease risk of the country he or she left behind. If he emigrates as a child, he ames the risk of disease in the new destination country. Vitamin D has been shown experimentally to have numerous immunomodulatory effects. Anti-inflammatory effects are shown. Most MS patients have a vitamin D deficiency, in some cases this was already present at birth. In addition, higher vitamin D levels have been shown to be associated with a lower risk of developing MS. Also, higher vitamin D levels could be associated with lower disease activity. Nevertheless, it is not yet clear whether the altered vitamin D level in MS patients is a consequence or a cause of the disease. One should also be careful with sun exposure: with increasing exposure to the sun, the risk of skin cancer rises.
The sun plays the decisive role in the formation of vitamin D. A deficiency damages especially the bones
What role does lifestyle play??
Smokers are 1.5 times more likely to develop multiple sclerosis than non-smokers. Increasingly also a possible connection between nutrition, intestine flora and multipler Sclerosis moves into the focus. In laboratory experiments scientists found out that the intestinal flora could be involved in the development of MS.
The influence of infections
A clear "MS agent could not be identified so far. Various pathogens (e.g. Epstein-Barr virus, herpes viruses) are suspected to cause multiple sclerosis. Possibly "mixed up the immune system fatally attacks the body's own tie such as the enveloping layer of the nerve fibers with the germs – and attacks it. But, important to know: MS is by no means a contagious disease!