| Abstract | Multipla skleroza (MS) je autoimuna bolest koja prvenstveno zahvaća središnji živčani sustav (SŽS). Jedno od patoloških obilježja MS-a je povećana propusnost krvno-moždane barijere (BBB, prema engl. blood-brain barrier) što omogućuje ulazak autoreaktivnih stanica u SŽS gdje uzrokuju kroničnu upalu i oštećenje mijelina. Demijelinizacijom se narušava prijenos akcijskog potencijala koji je esencijalan za motoričke, senzoričke i kognitivne funkcije. Budući da do demijelinizacije može doći u bilo kojem dijelu SŽS-a bolest se očituje brojnim simptomima, a neki od njih su slabost mišića, umor, problemi s vidom, problemi s kognicijom te mnogi drugi. Epstein-barr virus (EBV) je herpesvirus te se njegov životni ciklus sastoji od primarne infekcije koja započinje infekcijom epitelnih stanica te je u djece najčešće asimptomatska, dok u adolescenata i odraslih najčešće rezultira infektivnom mononukleozom. Potom virus uspostavlja latentnu fazu inficiranjem B limfocita, a budući da u latentnoj fazi gotovo i nema ekspresije gena postaje nevidljiv za imunosni sustav. Stanja poput stresa, kronične bolesti i imunosupresije mogu potaknuti litičku reaktivaciju čime virus ponovno ima sposobnost infekcije drugih stanica. EBV se dugi niz godina povezuje s MS-om, a novija istraživanja jasno pokazuju njegovu nužnost u patogenezi MS-a u genetski predisponiranih osoba. Iako mehanizam bolesti nije razjašnjen, nagađa se kako je molekularna mimikrija jedan od mogućih patogenetskih mehanizama. Kako je disfunkcija imunosnog sustava najvažnija za razvoj MS-a sve danas dostupne terapije fokusiraju se na njegovu regulaciju. Budući da je poznata važnost EBV-a u patogenezi MS-a, provedeno je nekoliko istraživanja za učinkovitost antiviralnih lijekova, no nisu pokazala zadovoljavajuće rezultate. Stoga je sve više istraživanja usmjereno na razvoj polivalentnih cjepiva kojima bi se mogla spriječiti primarna infekcija. |
| Abstract (english) | Multiple sclerosis (MS) is an autoimmune disease that primarily affects the central nervous system (CNS). One of the pathological features of MS is the increased permeability of the blood-brain barrier (BBB), which allows autoreactive cells to enter the CNS, where they cause chronic inflammation and damage to myelin. Demyelination impairs the transmission of the action potential, which is essential for motor, sensory and cognitive functions. Since demyelination can occur in any part of the CNS, the disease is manifested by numerous symptoms, some of which are muscle weakness, fatigue, vision problems, cognitive problems, and many others. Epstein-Barr virus (EBV) is a herpesvirus and its life cycle consists of a primary infection that begins with an infection of epithelial cells, which is most often asymptomatic in children, while in adolescents and adults it most often results in infectious mononucleosis. The virus then establishes a latent phase by infecting B lymphocytes, and since there is almost no gene expression in the latent phase, it becomes invisible to the immune system. Conditions such as stress, chronic illness, and immunosuppression can trigger lytic reactivation, whereby the virus regains the ability to infect other cells. EBV has been associated with MS for many years, and recent research clearly shows its necessity in the pathogenesis of MS in genetically predisposed individuals. Although the mechanism of the disease has not been clarified, it is speculated that molecular mimicry is one of the possible pathogenetic mechanisms. As the dysfunction of the immune system is the most important for the development of MS, all therapies available today focus on its regulation. Since the discovery of the importance of EBV in MS pathogenesis, several studies have been carried out for the effectiveness of antiviral drugs, but they did not show satisfactory results. Therefore, more and more research is focusing on the development of polyvalent vaccines that could prevent primary EBV infection. |
