The epidemiology of microbial agents related to patients with multiple sclerosis (MS)

Masoumeh Navidinia, Khadijeh Gholinejad, Safoura Derakhshan, Ali Rahimipour, Faranak Kazerouni, Mohammad Ali Sahraian



     Multiple Sclerosis (MS) is one of the autoimmune diseases which affects the central nervous system and its etiology has not yet been identified. The disparity between youth and disability in reproductive ages is considered to be of particular importance for this disease and the need for research which illuminates various epidemiological, etiologic, clinical and therapeutic angles of multiple sclerosis is deeply felt. The purpose of this study is to consider the epidemiology of microbial agents related to patients with multiple sclerosis (MS). From 37 patients with multiple sclerosis according to the physician examination and McDonald criteria , serum samples were taken. Until testing, serum samples were stored in a freezer at -70 ° C. Subsequently, viral and bacterial agents were identified using specific primers and PCR method. In this study, the numbers of microbial agents were as the following: 7 retrovirus associated with MS (MRSV), 17 EBV, 8 HSV6, 11 JC virus, 10 CMV, 8 B19, 14Corona virus, 1 Helicobacter pylori, 15 Acinetobacter, 9 Borrelia burgdorferi, and 19 Chlamydia pneumonia. Identification of the relationship between different infectious agents in MS is necessary to prepare feasible data about tracing and treatment of MS related to these microorganisms that may be beneficial to clinicians to select a convenient empirical therapeutic diet in MS related to pathogens at the bedhead and can open up a new path to new therapeutic approaches.



Multiple Sclerosis patients, Microbial Agents, PCR

Full Text:




Milo R, Miller A. Revised diagnostic criteria of multiple sclerosis. Autoimmunity Reviews 2014; 13: 518–524.

Izadi S, Nikseresht AR, Sharifian M, Sahraian MA, Hamidian Jahromi A, Aghighi M, Heidary AR. Significant Increase in the Prevalence of Multiple Sclerosis in Iran in 2011. Iran J Med Sci 2014; 39(2):152-153.

.Compston A, Coles A. Multiple Sclerosis. Lancet. 2008; 372:1502-17.

Weiner HL. Multiple sclerosis is an inflammatory T-cell-mediated autoimmune disease. Arch Neurol. 2004; 61:1613-5.

Sturm D, Gurevitz SL, Turner A.Multiple Sclerosis: A Review of the Disease and Treatment Options. Consult Pharm 2014; 29(7):469-79.

Eskandareieh S, Heydarpour P, Elhami SR, Sahraian MA.Prevalence and Incidence of Multiple Sclerosis in Tehran, Iran.Iran J Public Health 2017; 46(5): 699–704.

Melcon M, Correale J, Melcon C. Is it time for a new global classification of multiple sclerosis?J Neurol Sci 2014; 344(1–2):171–81.

Dua T, Romani P. Atlas of Multiple Sclerosis Resources in the World, WHO, Geneva. 2008

Heydarpour P, Khoshkish S, Abtahi S, Moradi-Lakeh M, Sahraian MA. (2015). Multiple Sclerosis Epidemiology in Middle East and North Africa: A Systematic Review and Meta-Analysis. Neuroepidemiol 2015; 44(4):232–244.

Milo R, Kahana E. Multiple sclerosis: geoepidemiology, genetics and the environment. Autoimmun Rev 2010; 9: 387–94.

Gale CR, Martyn CN. Migrant studies in multiple sclerosis. Prog Neurobiol 1995; 47:425–48.

Kurtzke JF. Epidemiology in multiple sclerosis: a pilgrim's progress. Brain 2013;136:2904–17.

Wu C, Yosef N, Thalhamer T, Zhu C, Xiao S, Kishi Y, et al. Induction of pathogenic TH17 cells by inducible salt-sensing kinase SGK1. Nat 2013; 496:513–7.

Kleinewietfeld M, Manzel A, Titze J, Kvakan H, Yosef N, Linker RA, et al. Sodium chloride drives autoimmune disease by the induction of pathogenic TH17 cells. Nat 2013; 496:518–22.

Moosazadeh M, Esmaeili R, Nasehi MM, Abedi G, Afshari M, Farshidi F, Kheradmand M.Prevalence of familial multiple sclerosis in Iran: A systematic review and meta-analysis.Iran J Neurol 2017 4; 16(2): 90–95.

Etemadifar M, Janghorbani M, Shaygannejad V, Ashtari F. Prevalence of multiple sclerosis in Isfahan, Iran. Neuroepidemiol. 2006; 27:39-44.

United States Census Bureau. International Data Base-Iran. [Cited 2011 May 22]. Available from:

Izadi S, Nikseresht AR, Sharifian M, Sahraian MA, Hamidian Jahromi A, Aghighi M, Heidary AR. Significant Increase in the Prevalence of Multiple Sclerosis in Iran in 2011. Iran J Med Sci 2014;39(2):152-153. .Guidelines for MS diagnosis: McDonald Criteria

Hassan R, White LR, Stefanoff CG, Oliveira DE, Felisbino FE, Klumb CE, et al. Epstein-Barr Virus (EBV) detection and typing by PCR: a contribution to diagnostic screening of EBV-positive Burkitt's lymphoma. Diag Pathol 2006, 1:17. doi:10.1186/1746-1596-1-17.

Flamand L, Gravel A, Boutolleau D, Alvarez-Lafuente R, Jacobson S, Malnati MS, Kohn D,et al.Multicenter Comparison of PCR Assays for Detection of Human Herpesvirus 6 DNA in Serum. J Clin Microbiol 2008;46(8): 2700–2706.

Wang J, Ruan Z, Feng Y, Fu Y, Jiang Y, WangH, Yu Y.Species Distribution of Clinical Acinetobacter Isolates Revealed by Different Identification Techniques.PLoS One. 2014; 9(8): e104882.

Plnar A, Bozdemir N, Kocagöz T, Alaçam R. Rapid Detection of Bacterial Atipical Pneumonia Agents by Multiplex PCR. Cent Eur J Publ Health 2004; 12 (1): 3-5

A case of a progressive multifocal leukoencephalopathy patient with four different JC virus transcriptional control region rearrangements in cerebrospinal fluid, blood, serum, and urine .J NeuroVirol 2005; 11(1): 51–5.

Daly P, Corcoran A, Mahon BP, Doyle S. High-Sensitivity PCR Detection of Parvovirus B19 in Plasma. J Clin Microbiol 2002; 40(6): 1958–1962.

Jeziorski E, Foulongne V , Ludwig C , Louhaem D , Rodiere M , Sitbon M, et al.Searching for Common Mammalian Retroviruses in Pediatric Idiopathic Diseases. Viruses 2016; 8(86). doi:10.3390/v8030086

Eshoo MW, Crowder CC, Rebman AW, Rounds MA, Matthews HE, Picuri JM, et al. (2012) Direct Molecular Detection and Genotyping of Borrelia burgdorferi from Whole Blood of Patients with Early Lyme Disease. PLoS ONE 7(5): e36825.

Brola W, Sobolewski P, Flaga S, Fudala M, Szczuchniak W, Stoinski J, et al. Prevalence and incidence of multiple sclerosis in central Poland, 2010–2014 . BMC Neurol 2016; 16:134 .DOI 10.1186/s12883-016-0662-8

Khaki M , Ghazavi A , Ghasami K , Rafei M , Payani M , Mosayebi G . Anti-human herpes virus-6 antibodies titer in patients with multiple sclerosis in Markazy Province .J Arak Uni Med Sci Ori Art 2009; 12(2): 45-50.

Mohebi N, Mamarabadi M, Moghaddasi M. Evaluation of the relation between Helicobacter pylori and Multiple sclerosis. Razi J Med Sci 2013; 19(105): 17-22.

Hughes LE, Bonell S, Natt RS, Wilson C, Tiwa na H, Ebringer A, et al. Antibody responses to Acinetobacter spp. and Pseudomonas aeruginosa in multiple sclerosis: prospects for diagnosis using the myelin-acinetobacter-neurofilament antibody index. Clin Diagn Lab Immunol 2001; 8(6): 1181-8.

Chmielewska-Badora J, Cisak E, Dutkiewicz J. Lyme borreliosis and multiple sclerosis: any connection? A seroepidemic study. Ann Agric Environ Med 2000; 7(2): 141-3.

Friedman JE, Lyons MJ, Cu G, Ablashl DV, Whitman JE, Edgar M, et al. The association of the human herpesvirus-6 and MS. Mult Scler1999; 5(5): 355-62.

Wandinger K, Jabs W, Siekhaus A, Bubel S, Trillenberg P, Wagner H, et al. Association between clinical disease activity and Epstein-Barr virus reactivation in MS. Neurol 2000; 55(2): 178-84

Stoner GL, Agostini HT, Ryschkewitsch CF, Baumhefner RW, Tourtellotte WW. Characterization of JC virus DNA amplified from urine of chronic progressive multiple sclerosis patients. Mult Scler 1996; 1(4): 193-9.

Agostini HT, Ryschkewitsch CF, Baumhefner RW, Tourtellotte WW, Singer EJ, Komoly S, et al. Influence of JC virus coding region genotype on risk of multiple sclerosis and progressive multifocal leukoencephalopathy. J Neurovirol 2000; 6(2): 101-108.

Ferrante P, Omodeo-Zorini E, Caldarelli-Stefano R, Mediati M, Fainardi E, Granieri E, et al. Detection of JC virus DNA in cerebrospinal fluid from multiple sclerosis patients. Mult Scler1998; 4(2): 49-54.

Stewart JN, Mounir S, Talbot PJ. Human coronavirus gene expression in the brains of multiple sclerosis patients. Virol 1992; 191(1): 502-5.

Nakashima I, Fujihara K, Itoyama Y. Human parvovirus B19 infection in multiple sclerosis. Eur Neurol 1999; 42(1): 36-40.

Garcia-Montojo M, Dominguez-Mozo M, Arias-Leal A, Garcia-Martinez A, De las Heras V, et al. The DNA Copy Number of Human Endogenous Retrovirus-W (MSRV-Type) Is Increased in Multiple Sclerosis Patients and Is Influenced by Gender and Disease Severity. PLoS ONE 2013; 8(1): e53623.

Handel AE, Williamson AJ, Disanto G, Handunnetthi L, Giovannoni G, et al. An Updated Meta-Analysis of Risk of Multiple Sclerosis following Infectious Mononucleosis. PLoS ONE 2010; 5(9): e12496.

Sanadgol M, Ramroodi N, Ali Ahmadi Gh, Komijani M, Moghtaderi A, Bouzari M, et al. Prevalence of cytomegalovirus infection and its role in total immunoglobulin pattern in Iranian patients with different subtypes of multiple sclerosis. New Microbiologica 2011; 34: 263-74.

Hughes LE, Bonell S, Natt RS, Wilson C, Tiwana H, Ebringer A, et al. Antibody responses to Acinetobacter spp. and Pseudomonas aeruginosa in multiple sclerosis: prospects for diagnosis using the myelin – Acinetobacter – neurofilament antibody index. Clin Diagon Lab Immunal 2001; 8:1181-8.

Sriram S, Stratton CW, Yao S, et al. Chlamydia pneumoniae infection of the central nervous system in multiple sclerosis. Ann Neurol 1999; 46:6–14.

Fainardi E, Castellazzi M, Tamborino C, et al. Chlamydia pneumoniae-specific intrathecal oligoclonal antibody response is predominantly detected in a subset of multiple sclerosis patients with progressive forms. J Neuro Virol 2009; 15:425–433.

Bagos PG, Nikolopoulos G, Ioannidis A. Chlamydia pneumoniae infection and the risk of multiple sclerosis: a meta-analysis. Mult Scler 2006; 12:397–411.



  • There are currently no refbacks.

"Journal of Paramdedical Sciences", is a publication of "School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences" and "Iranian Society of Medical Proteomics".

"Journal of Paramdedical Sciences" is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


EISSN: 2008-4978

PISSN: 2008-496X