scholarly journals The role of epidemiology in MS research: Past successes, current challenges and future potential

2015 ◽  
Vol 21 (8) ◽  
pp. 969-977 ◽  
Author(s):  
Steve Simpson ◽  
Bruce V Taylor ◽  
Ingrid van der Mei
Keyword(s):  
Clinical Course ◽  
Epidemiological Methods ◽  
Past Century ◽  
Environment Interaction ◽  
Related Factors ◽  
Barr Virus ◽  
Gene Environment ◽  
Drb1 Locus ◽  
Epstein Barr ◽  
Epidemiological Characteristics

Multiple sclerosis (MS) is a multifaceted condition, with a range of environmental, behavioural and genetic factors implicated in its aetiology and clinical course. Successes in advancing our appreciation of the roles of Epstein-Barr virus, vitamin D/UV and the HLA-DRB1 locus; and our greater understanding of these and related factors’ modes of action in MS and other conditions, can be attributed in no small part to the work of generations of epidemiologists. Hardly content to rest on our laurels, however, there are yet a range of unsolved conundrums in MS, including some changes in epidemiological characteristics (e.g. increasing incidence and sex ratio), to say nothing of the unresolved parts regarding what underlies MS risk and its clinical course. There is evidence that epidemiology will continue to play a crucial role in unravelling the architecture of MS causation and clinical course. While classic epidemiological methods are ongoing, novel avenues for research include gene-environment interaction studies, the world of ‘-omic’ research, and the utilisation of mobile and social media tools to both access and track study populations, which means that the epidemiological discoveries of the past century may be but a glimpse of our understanding in the next few decades.

Cytomegalovirus-Associated Hemophagocytic Syndrome

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 280-283
Author(s):  
ELIZABETH H. DANISH ◽  
BEVERLY B. DAHMS ◽  
MARY L. KUMAR
Keyword(s):  
Viral Infection ◽  
Epstein Barr Virus ◽  
Hemophagocytic Syndrome ◽  
Clinical Course ◽  
Underlying Disease ◽  
Barr Virus ◽  
Pathologic Findings ◽  
Immunosuppressed Patients ◽  
Epstein Barr ◽  
Herpes Group

Virus-associated hemophagocytic syndrome, first described by Risdall and co-workers in 1979,1 is a rare histiocytic proliferative syndrome characterzed by fever, hepatosplenomegaly, pancytopenia, and erythrophagocytosis by histiocytes that appear benign by histologic criteria. The clinical course and pathologic findings may be identical with another histiocytic disorder, familial erythrophagocytic lymphohistiocytosis, which occurs predominantly in infants. Diagnosis of virus-associated hemophagocytic syndrome depends entirely on evidence of concurrent viral infection, usually of the herpes group. Epstein-Barr virus has been associated with this syndrome in the few cases reported in children without underlying disease, whereas cytomegalovirus (CMV) has been implicated in immunosuppressed patients. We report a case of fatal CMV-associated hemophagocytic syndrome which occurred in a previously healthy infant.

Correlation of Epstein-Barr virus DNA in cell-free plasma, functional imaging and clinical course in locally advanced nasopharyngeal cancer: A pilot study

Head & Neck ◽  
2004 ◽  
Vol 26 (9) ◽  
pp. 815-822 ◽  
Author(s):  
Antti A. Mäkitie ◽  
Patricia P. Reis ◽  
Jonathan Irish ◽  
Tong Zhang ◽  
Soo F. Chin ◽  
...  
Keyword(s):  
Pilot Study ◽  
Functional Imaging ◽  
Epstein Barr Virus ◽  
Clinical Course ◽  
Locally Advanced ◽  
Nasopharyngeal Cancer ◽  
Barr Virus ◽  
Epstein Barr ◽  
Free Plasma

scholarly journals Deficiency of CD8+ effector memory T cells is an early and persistent feature of multiple sclerosis

2014 ◽  
Vol 20 (14) ◽  
pp. 1825-1832 ◽  
Author(s):  
Michael P Pender ◽  
Peter A Csurhes ◽  
Casey MM Pfluger ◽  
Scott R Burrows
Keyword(s):  
Multiple Sclerosis ◽  
T Cells ◽  
T Cell ◽  
Epstein Barr Virus ◽  
Clinical Course ◽  
Effector Memory ◽  
Barr Virus ◽  
Effector Memory T Cells ◽  
The Central Nervous System ◽  
Epstein Barr

Background: Patients with multiple sclerosis (MS) have a deficiency of circulating CD8+ T cells, which might impair control of Epstein–Barr virus (EBV) and predispose to MS by allowing EBV-infected autoreactive B cells to accumulate in the central nervous system. Based on the expression of CD45RA and CD62L, CD4+ T cells and CD8+ T cells can be subdivided into four subsets with distinct homing and functional properties, namely: naïve, central memory, effector memory (EM) and effector memory re-expressing CD45RA (EMRA) cells. Objective: Our aim was to determine which memory subsets are involved in the CD8+ T cell deficiency and how these relate to clinical course. Methods: We used flow cytometry to analyze the memory phenotypes of T cells in the blood of 118 MS patients and 112 healthy subjects. Results: MS patients had a decreased frequency of EM (CD45RA–CD62L–) and EMRA (CD45RA+CD62L–) CD8+ T cells, which was present at the onset of disease and persisted throughout the clinical course. The frequencies of CD4+ EM and EMRA T cells were normal. Conclusion: Deficiency of effector memory CD8+ T cells is an early and persistent feature of MS and might underlie the impaired CD8+ T cell control of EBV.

Understanding Multiple Sclerosis Better in 2014 – Environmental Factors, Remyelination, Diagnostic Techniques, Treatment Decisions and the Future Focus of Multiple Sclerosis Treatment

2015 ◽  
Vol 10 (2) ◽  
pp. 148 ◽  
Author(s):  
Hüsnü Efendi ◽  
Rana Karabudak ◽  
Orhun Kantarci ◽  
Aksel Siva ◽  
◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Predictive Biomarkers ◽  
Symptomatic Treatment ◽  
Diagnostic Techniques ◽  
Main Concern ◽  
Barr Virus ◽  
Gene Environment ◽  
Repurposed Drugs ◽  
Epstein Barr ◽  
Magnetic Resonance Imaging Mri

Epidemiological factors, such as vitamin D, Epstein–Barr virus, smoking and adolescent obesity, are associated with multiple sclerosis (MS) susceptibility and may be involved in MS aetiology. There is also evidence of gene–environment interactions. Both validated predictive biomarkers and gene-expression data will play a crucial role in future diagnosis of MS and prognosis facilitating early treatment and improving management. Understanding the mode of action of disease-modifying therapies (DMTs) should also enhance MS management by identifying the best treatment for different stages of the disease course. Magnetic resonance imaging (MRI) plays a significant role in both diagnosis and monitoring of patients and is likely to become part of the daily MS practice using standardised protocols and software to increase reproducibility. A future goal of MS treatment is to facilitate neuron repair and remyelination. In this respect, animal models of remyelination could be useful in identifying potential therapies. Diagnosis of radiological syndrome is now simpler, but its management is controversial and it does not always convert to MS. In addition, treatment for progressive MS is problematic as current DMTs are indicated only for relapsingremitting MS. Symptomatic treatment is a neglected aspect of MS management, which is often the main concern of both patients and neurologists. Neurologists need to collaborate in trials and consider repurposed drugs that could provide treatment for these symptoms. The second MS Days meeting provided a valuable platform for these critical topics to be discussed and novel solutions to be considered.

Adult Respiratory Papillomatosis: Human Papillomavirus Type and Viral Coinfections as Predictors of Prognosis

1995 ◽  
Vol 104 (10) ◽  
pp. 758-762 ◽  
Author(s):  
Anna Maria Pou ◽  
Frank L. Rimell ◽  
Jeanne A. Jordan ◽  
Pierre Barua ◽  
David L. Shoemaker ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Epstein Barr Virus ◽  
Clinical Course ◽  
Laryngeal Papillomatosis ◽  
Barr Virus ◽  
Polymerase Chain ◽  
Epstein Barr ◽  
Simplex Virus ◽  
Aggressive Clinical Course ◽  
The Relationship

Pathologic material and the records of 29 patients with laryngeal papillomatosis were reviewed. The relationship between the type of human papillomavirus (HPV) and the presence of viral coinfections was correlated with clinical outcome. Using polymerase chain reaction, paraffin-embedded specimens were analyzed for the presence of HPV, Epstein-Barr virus (EBV), cytomegalovirus (CMV), and herpes simplex virus (HSV). The HPV type could be identified in 24 patients' specimens. Twenty-one patients were infected with HPV type 6. The other 3 were infected with HPV type 11 or 16. Three patients developed squamous cell carcinoma, of whom 2 had HPV type 11 or 16. We found HSV, EBV, and CMV in 50%, 12.5%, and 0% of specimens, respectively. An aggressive clinical course was observed in 17 patients. Evidence of coinfection with other viruses was identified in 11 (65%) of these patients. In contrast, a benign clinical course was observed in 7 patients, of whom 2 (29%) had viral coinfections. We conclude that the HPV type and the presence of viral coinfections may be predictive of an aggressive clinical course.

scholarly journals Diagnosis of Oral Hairy Leukoplakia: The Importance of EBV In Situ Hybridization

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Luana L. Martins ◽  
José Henrique F. Rosseto ◽  
Natália Silva Andrade ◽  
Juliana Bertoldi Franco ◽  
Paulo Henrique Braz-Silva ◽  
...  
Keyword(s):  
In Situ Hybridization ◽  
Gold Standard ◽  
Epstein Barr Virus ◽  
Definitive Diagnosis ◽  
Barr Virus ◽  
Oral Hairy Leukoplakia ◽  
Hairy Leukoplakia ◽  
Epstein Barr ◽  
Epidemiological Characteristics

Oral hairy leukoplakia (OHL) is caused by the Epstein-Barr virus (EBV), which has been related to HIV infection. In situ hybridization (ISH) is the gold-standard diagnosis of OHL, but some authors believe in the possibility of performing the diagnosis based on clinical basis. The aim of this study is diagnose incipient lesions of OHL by EBV ISH of HIV-infected patients and the possible correlations with clinical characteristics of the patients. Ninety-four patients were examined and those presenting with clinical lesions compatible to OHL were submitted to biopsy prior to EBV ISH. Twenty-eight patients had lesions clinically compatible to the diagnosis of OHL, but only 20 lesions were confirmed by EBV ISH. The patients with OHL had a mean age of 41.9 years and were HIV-infected for 11.2 years, on average, including CD4 count of 504.7 cells/mm3 and log10 viral load = 1.1. Among the quantitative variables, there was a statistically significant correlation with age only (P=0.030). In conclusion, the presence of OHL in patients with HIV/AIDS results in changes in the epidemiological characteristics of the disease, and this fact allied with subtle clinical-morphological features makes clinical diagnosis very difficult. Therefore, EBV ISH is important for a definitive diagnosis of OHL.

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