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  • Updated 04.30.2024
  • Released 10.17.2012
  • Expires For CME 04.30.2027

Multiple sclerosis: biological differences in children and adults



Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease affecting the central nervous system. Although rare in the pediatric population, its onset in the youth population is becoming increasingly recognized. Because the developing nervous system is a particularly susceptible target of the immune system, children with multiple sclerosis represent a group in whom a strategy of relapse prevention and maintenance therapy may prevent long-term disability. The behavior of the immune system in children with multiple sclerosis appears to be distinct from that that of other autoimmune disorders. The potential for enhanced neural plasticity in children provides a unique opportunity for a meaningful recovery along with long-term disability prevention. Furthermore, there is evidence suggesting that molecular mimicry may play a causal role in a subset of early-onset multiple sclerosis groups (51). This may be associated with an Epstein Barr virus infection or other viral infection as a cause of the disease (51). In addition, glial cell adhesion molecule expressed on some glial cells, such as astrocytes and oligodendrocytes, have been associated with the presence EBNA1 antibodies. They were found in the B-cell clonal expansions from the CSF of patients with early multiple sclerosis who presented with clinically isolated syndrome versus an acute relapse of this disease.

Key points

• Epidemiological data support the etiology of multiple sclerosis as a parainfectious process, such as Epstein-Barr virus infection.

• Development of chronic inflammation occurs in susceptible individuals on the basis of the individual’s immune responses to antigenic stimuli.

• The central nervous system provides targets that result in chronic inflammatory responses, some of which are very severe in children.

• Age is an independent variable that, at least in part, determines the progression of disease in multiple sclerosis.

• Monitoring effective treatments with appropriate biomarkers is important in preventing long-term disability.

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ISSN: 2831-9125