The role of EBV and HHV-6 infection in demyelinating disease with a consideration of past UVR exposure.

在过去的50年里，免疫疾病的显著增加被认为反映了现代环境和生活方式的因素，而不是诊断的变化。有最多证据支持的假说是“卫生假说”。也就是说，现代儿童早期感染的减少会导致免疫系统功能障碍，从而导致免疫紊乱的增加。儿童延迟感染，特别是eb病毒感染与多发性硬化症（MS）风险有潜在关联。该项目旨在记录疱疹病毒（EBV, HHV-6）感染在首次脱髓鞘事件发病中的作用，这是多发性硬化症的前兆。该建议的优势在于它存在于现有的研究框架- Ausimmune研究中，允许详细探索与纬度、早期婴儿接触和过去阳光照射的相关关系。1961年至1996年，澳大利亚纽卡斯尔的多发性硬化症发病率从1.2-10万增加到2.4-10万，翻了一番。虽然发病率很低，但该病首次发病的中位年龄为24岁，即使接受免疫调节治疗也会发展为严重残疾（50%的人在13年内需要辅助行走），因此，目前塔斯马尼亚州每1,000名成年人中有1人患病，纽卡斯尔每1,000名成年人中有0.8人患病，这是一个严重的发病率负担。

The marked increase in immune disorders over the past fifty years is thought to reflect modern environmental and lifestyle factors, rather than changes in diagnosis. The hypothesis that has the most evidence to support it is the 'hygiene hypothesis'. That is, that a reduction in early life infection among modern children leads to immune system dysfunction and thus an increase in immune disorders. Delayed child infection, particularly of Epstein-Barr Virus has been prospectively linked to multiple sclerosis (MS) risk. This project aims to document the role of herpes virus (EBV, HHV-6) infection in the onset of first demyelinating events, a precursor to MS. The strength of this proposal is that it lies within an existing study framework - the Ausimmune Study, allowing detailed exploration of related associations with latitude, early life infant contact and past sun exposure. The incidence of MS has doubled from 1.2-100,000 to 2.4-100,000 from 1961 to 1996 in Newcastle, Australia. Although incidence is low, the disease has a median age of first onset of 24 years and progresses to serious disability even with immunomodulatory therapy (50% will need assistance in walking within 13 years) thus the current prevalence of 1 per 1,000 adults in Tasmania and 0.8 per 1,000 in Newcastle represent a serious burden of morbidity.