Current Advances in Pediatric Onset Multiple Sclerosis

Fisher, Kristen; Cuascut, Fernando X.; Rivera, Víctor M.; Hutton, George J.

doi:10.3390/biomedicines8040071

Cited by 30 publications

(25 citation statements)

References 110 publications

(142 reference statements)

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“…Seroconversion from negative to positive for EBV Abs generally increases with age. It has a major incidence peak early in childhood and shows a second peak, especially for females, around puberty, co-incident with the approximate age of IM and co-incident with the female predominance in MS (3,103,104,106,(125)(126)(127)(128). EBV infection correlates with pediatric MS and essentially all children with MS are found to be positive for EBV Abs, whereas the positivity rate is considerably lower in healthy children (54,(129)(130)(131)(132).…”

Section: Ebv and Msmentioning

confidence: 99%

Epstein-Barr Virus and Multiple Sclerosis

2020

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Multiple sclerosis (MS) is a neurologic disease affecting myelinated nerves in the central nervous system (CNS). The disease often debuts as a clinically isolated syndrome, e.g., optic neuritis (ON), which later develops into relapsing-remitting (RR) MS, with temporal attacks or primary progressive (PP) MS. Characteristic features of MS are inflammatory foci in the CNS and intrathecal synthesis of immunoglobulins (Igs), measured as an IgG index, oligoclonal bands (OCBs), or specific antibody indexes. Major predisposing factors for MS are certain tissue types (e.g., HLA DRB1*15:01), vitamin D deficiency, smoking, obesity, and infection with Epstein-Barr virus (EBV). Many of the clinical signs of MS described above can be explained by chronic/recurrent EBV infection and current models of EBV involvement suggest that RRMS may be caused by repeated entry of EBV-transformed B cells to the CNS in connection with attacks, while PPMS may be caused by more chronic activity of EBV-transformed B cells in the CNS. In line with the model of EBV’s role in MS, new treatments based on monoclonal antibodies (MAbs) targeting B cells have shown good efficacy in clinical trials both for RRMS and PPMS, while MAbs inhibiting B cell mobilization and entry to the CNS have shown efficacy in RRMS. Thus, these agents, which are now first line therapy in many patients, may be hypothesized to function by counteracting a chronic EBV infection.

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Section: Ebv and Msmentioning

confidence: 99%

Epstein-Barr Virus and Multiple Sclerosis

2020

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“…Evidence of DMT's effectiveness in reducing relapse rates and disease progression in children with MS is primarily based on observational studies. The number of approved DMT drugs for use in children and adolescents with MS is limited [1]. None of these drugs, except for fingolimod (PARADIGMS study), have been evaluated in a paediatric population in randomised, double-blind studies with a control group receiving active treatment [59,60].…”

Section: Disease-modifying Therapy (Dmt)mentioning

confidence: 99%

“…teriflunomide). However, these drugs have more side effects in children than do interferon beta or glatiramer acetate [1].…”

Section: Second-line Treatmentmentioning

confidence: 99%

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Pediatric multiple sclerosis – current status of epidemiology, diagnosis and treatment

Brola

Steinborn

2020

Neurol Neurochir Pol.

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Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of the central nervous system that mostly affects younger adults. However, the first symptoms of MS can appear in children and adolescents before the age of 18, and we call this paediatric MS (PMS).It is estimated that paediatric MS accounts for 3-5% of the general population of patients with MS. Despite the fundamental similarities to adult MS, PMS has many distinctive features. Paediatric MS has a milder course compared to adults, but leads to significant disability at an early age. PMS is relapsing-remitting in 95-98% of cases; the primary progressive manifestation is much less common than in adults. The differential diagnosis of MS in children should include other childhood demyelinating diseases, mitochondrial and metabolic diseases, connective tissue diseases, and neuroborreliosis. Differentiating acute disseminated encephalomyelitis (ADEM) from the first onset of MS remains the biggest challenge. Over the past 10 years, understanding of the epidemiology, pathophysiology, diagnosis, and treatment of MS in children has significantly expanded. The diagnostic criteria leading to earlier diagnosis and initiation of disease-modifying therapy (DMT) have changed, and the number of drugs used in children has increased. However, many important issues require further research. This review discusses the current state of knowledge regarding the epidemiology, diagnosis, and treatment of multiple sclerosis in children.

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“…In adolescents, the ratio of females to males with MS increases to 2 to 3:1, similar to the gender distribution in adults. A review study [ 10 ] emphasizes the development of the International Pediatric MS Study Group in 2005 as a milestone in the progress of the knowledge base surrounding pediatric MS, including clinical manifestations and possibilities of treatment.…”

mentioning

confidence: 99%

Editorial of Special Issue “Multiple Sclerosis: Diagnosis and Treatment II”

Rivera

2021

Biomedicines

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The special issue on Multiple Sclerosis: Diagnosis and Treatment II, reflects advances and discoveries in the molecular and cellular mechanisms of disease, and novel laboratory techniques providing more sensitivity to diagnostic techninques and the understanding of neuroinflammation. Mitochondrial-mediated apoptosis in isolated peripheral blood mononuclear cells and the role of reactive oxygen species are studied as indicators of activity of MS. In these cells, downregulation of circular and linera RNAs are reported as markers of highly active disease in MS. Progress and importance of Neurofilaments determinations in early diagnosis and as a marker of disease activity, and the analysis of the complex mechanisms and therapeutic potential of Sphingosine-1-phosphate receptor modulator are discussed. Epidemiologic observations from a highly diversified area of the world provide more insights into this important aspect of MS; discussions on the clinical challenges posed by spinal cord involvement in demyelinatind disorders and the latest aspects of pediatric onset MS, complement this fine collection of scientific papers.

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Current Advances in Pediatric Onset Multiple Sclerosis

Cited by 30 publications

References 110 publications

Epstein-Barr Virus and Multiple Sclerosis

Epstein-Barr Virus and Multiple Sclerosis

Pediatric multiple sclerosis – current status of epidemiology, diagnosis and treatment

Editorial of Special Issue “Multiple Sclerosis: Diagnosis and Treatment II”

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