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Review

Infections, Vaccines and Autoimmunity: A Multiple Sclerosis Perspective

1
Buffalo Neuroimaging Analysis Center, Department of Neurology, University at Buffalo, State University of New York, Buffalo, NY 14203, USA
2
Jacobs MS Center, Department of Neurology, University at Buffalo, State University of New York, Buffalo, NY 14203, USA
3
School of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14214, USA
4
Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY 14203, USA
*
Author to whom correspondence should be addressed.
Received: 2 January 2020 / Revised: 21 January 2020 / Accepted: 24 January 2020 / Published: 28 January 2020
(This article belongs to the Special Issue Multiple Sclerosis and Its Complications: Clinical Trials)
Background: Multiple sclerosis (MS) is a chronic neuroinflammatory and neurodegenerative disease that is associated with multiple environmental factors. Among suspected susceptibility events, studies have questioned the potential role of overt viral and bacterial infections, including the Epstein Bar virus (EBV) and human endogenous retroviruses (HERV). Furthermore, the fast development of immunomodulatory therapies further questions the efficacy of the standard immunization policies in MS patients. Topics reviewed: This narrative review will discuss the potential interplay between viral and bacterial infections and their treatment on MS susceptibility and disease progression. In addition, the review specifically discusses the interactions between MS pathophysiology and vaccination for hepatitis B, influenza, human papillomavirus, diphtheria, pertussis, and tetanus (DTP), and Bacillus Calmette-Guerin (BCG). Data regarding potential interaction between MS disease modifying treatment (DMT) and vaccine effectiveness is also reviewed. Moreover, HERV-targeted therapies such as GNbAC1 (temelimab), EBV-based vaccines for treatment of MS, and the current state regarding the development of T-cell and DNA vaccination are discussed. Lastly, a reviewing commentary on the recent 2019 American Academy of Neurology (AAN) practice recommendations regarding immunization and vaccine-preventable infections in the settings of MS is provided. Conclusion: There is currently no sufficient evidence to support associations between standard vaccination policies and increased risk of MS. MS patients treated with immunomodulatory therapies may have a lower benefit from viral and bacterial vaccination. Despite their historical underperformance, new efforts in creating MS-based vaccines are currently ongoing. MS vaccination programs follow the set back and slow recovery which is widely seen in other fields of medicine. View Full-Text
Keywords: multiple sclerosis; immunization; DNA-vaccine; T-cell vaccine; influenza; hepatitis B; Epstein Barr virus multiple sclerosis; immunization; DNA-vaccine; T-cell vaccine; influenza; hepatitis B; Epstein Barr virus
MDPI and ACS Style

Jakimovski, D.; Weinstock-Guttman, B.; Ramanathan, M.; Dwyer, M.G.; Zivadinov, R. Infections, Vaccines and Autoimmunity: A Multiple Sclerosis Perspective. Vaccines 2020, 8, 50. https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines8010050

AMA Style

Jakimovski D, Weinstock-Guttman B, Ramanathan M, Dwyer MG, Zivadinov R. Infections, Vaccines and Autoimmunity: A Multiple Sclerosis Perspective. Vaccines. 2020; 8(1):50. https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines8010050

Chicago/Turabian Style

Jakimovski, Dejan, Bianca Weinstock-Guttman, Murali Ramanathan, Michael G. Dwyer, and Robert Zivadinov. 2020. "Infections, Vaccines and Autoimmunity: A Multiple Sclerosis Perspective" Vaccines 8, no. 1: 50. https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines8010050

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