an updated meta-analysis of risk of multiple sclerosis following infectious mononucleosis一个更新的荟萃分析多发性硬化症后传染性单核细胞增多症的风险.pdfVIP

An Updated Meta-Analysis of Risk of Multiple Sclerosis following Infectious Mononucleosis 1,2 3 1,2 1,2 Adam E. Handel , Alexander J. Williamson , Giulio Disanto , Lahiru Handunnetthi , Gavin Giovannoni4*, Sreeram V. Ramagopalan1,2,4* 1 Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom, 2 Department of Clinical Neurology, University of Oxford, Oxford, United Kingdom, 3 Department of Physical and Theoretical Chemistry, University of Oxford, Oxford, United Kingdom, 4 Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom Abstract Background: Multiple sclerosis (MS) appears to develop in genetically susceptible individuals as a result of environmental exposures. Epstein-Barr virus (EBV) infection is an almost universal finding among individuals with MS. Symptomatic EBV infection as manifested by infectious mononucleosis (IM) has been shown in a previous meta-analysis to be associated with the risk of MS, however a number of much larger studies have since been published. Methods/Principal Findings: We performed a Medline search to identify articles published since the original meta-analysis investigating MS risk following IM. A total of 18 articles were included in this study, including 19390 MS patients and 16007 controls. We calculated the relative risk of MS following IM using a generic inverse variance with random effects model. This showed that the risk of MS was strongly associated with IM (relative risk (RR) 2.17; 95% confidence interval 1.97–2.39; p,10254). Discussion: Our results establish firmly that a history of infectious mononucleosis significantly i