When first diagnosed with MS, one of the questions you may ask yourself is “how did this happen to me?” You may think that you did this right, and that right, so therefore that shouldn’t be happening. But as scientists are discovering, it’s not just one thing that causes the onset of multiple sclerosis, it’s usually a combination of several things.
What are these several things? Glad you asked. Usually the onset of MS is brought on by a combination of genetic factors, environmental factors, infectious factors an immunologic factors, as well as several others. So how do all these things interact to create an environment of autoimmunity? And more specifically, one where our own bodies attack the myelin of our nerves? Let’s dive in and find out.
Multiple sclerosis is not a 100% genetically inherited disease, but there is evidence that genes do play a role. When scientists and researchers have looked at patterns within families, they find that an individual that has a first, second or third degree relative who also has MS, they have an increased risk of developing the disease also. It’s also noted that if a sibling has MS, the individual has about a 5% higher risk of developing it as well. There are several genes that are believed to predispose someone to having MS and when an individual has these genes, the first piece of the MS puzzle is put into place.
The saying that I keep coming back to over and over, “genetics load the gun, environment pulls the trigger
“, couldn’t be more true in the case of MS. With the genetic predisposition already in place, certain environmental factors can make our bodies express those genes in certain ways. One major environmental factor that is widely known, is that MS is more prevalent in areas that are farther away from the equator. One possible reason for this as I have discussed in previous posts
, is that individuals who live further from the equator are exposed to less Vitamin D than individuals who are living near the equator.
MS “clusters” have also been documented, where the prevalence of MS has been noted to be higher than other places. Clusters have been noted in Faroe Islands; Galion, Ohio; DePue, Illinois; Rochester, New York; El Paso, Texas. Even though nothing has been proven regarding these clusters in terms of causation, it is an interesting place to start looking into possible environmental causes.
A note about environmental factors. It seems as though the age of 15 is important. If an individual lives in an area that seems to increase the risk for MS (like northern locations), but then they move, they will assume the new locations level of risk, if they move before they are 15. If the relocation happens after the age of 15, they will keep their original locations risk factors.
There are numerous infections, viruses and bacteria that have been investigated as a possible trigger to MS. Obviously viruses and bacteria cause inflammation and potentially the breakdown of myelin as well. Therefore it makes sense that a virus/bacteria/infection could cause MS. The infections that are being investigated for their link to MS are Herpes Virus, Epstein-Barr, Measles, Mumps and Rubella. Researchers are also looking into a common food borne illness as being a trigger as well. Clostridium perfringens is being investigated because of it’s ability to cross the Blood Brain Barrier and kill the myelin producing cells, oligodendrocytes; which are the cells that are affected when lesions are active. More studies are needed in this area, but it is very interesting research.
Other Potential Causes
There are several things that seem to have gained traction as possible causes yet have not be proven (at all). Lyme disease, heavy metals, canine distemper, smoking and gut bacteria are among these. It has been thought that lyme disease and heavy metal toxicity are at the root of MS. These are thought to be causes because they activate the immune system, have similar symptoms and specifically heavy metals can lead to an increase in free radicals.
Canine distemper is thought to be linked to MS due to the higher prevalence of cases when individuals had been exposed to a dog with a distemper like illness several years prior to the onset of their MS. Smoking is another possible activity that poses as a risk factor or has causation. There is contradicting evidence regarding whether or not this is actually a factor, but some research shows that an individual is more likely to have a second attack of MS, following the Clinically Isolated Syndrome, if they are a smoker.
Gut bugs! Read my post from last week to get the scoop on the brand new research regarding the link between gut microbes and MS.
It is clear that there are many possible causes of Multiple Sclerosis, however none of which have been completely proven. I believe it is safe to say that it is a combination of many of these things that creates an environment within our bodies that makes it possible for MS to start. It is encouraging to know that researchers are hard at work trying to figure out what the exact cause is so it can be prevented in the future.
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