Reducing infection risk in multiple sclerosis and neuromyelitis optica spectrum disorders: a Brazilian reference center's approach

Reducing infection risk in multiple sclerosis and neuromyelitis optica spectrum disorders: a Brazilian reference center's approach

Background Multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) are the most common autoimmune diseases of the central nervous system (CNS). They present chronic relapsing courses that demand treatment with disease-modifying drugs (DMDs) to prevent inflammatory activity. Disea...

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Main Authors: Ana Beatriz Ayroza Galvão Ribeiro Gomes, Lucas Bueno Feo, Guilherme Diogo Silva, Caio César Diniz Disserol, Renata Barbosa Paolilo, Amanda Nazareth Lara, Adriana Coracini Tonácio, Maria Fernanda Mendes, Samira Luísa Apóstolos Pereira, Dagoberto Callegaro
Format: Article
Language:English
Published: Thieme Revinter Publicações 2022-10-01
Series:Arquivos de Neuro-Psiquiatria
Subjects:
multiple sclerosis
neuromyelitis optica
vaccines
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1754348
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Summary:Background Multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) are the most common autoimmune diseases of the central nervous system (CNS). They present chronic relapsing courses that demand treatment with disease-modifying drugs (DMDs) to prevent inflammatory activity. Disease-modifying drugs lead to immunomodulation or immunosuppression through diverse mechanisms (e.g., shifting lymphocyte and cytokine profile, suppressing specific lymphocyte subpopulations). Thus, patients are more prone to infectious complications and associated worsening of disease. Objective To present feasible strategies for mitigating the infection risk of MS and NMOSD treated patients. Methods Targeted literature review concerning the management of infection risk with an emphasis on vaccination, therapy-specific measures, and particularities of the Brazilian endemic infectious diseases' scenario. Conclusion We propose a vaccination schedule, infectious screening routine, and prophylactic measures based on the current scientific evidence. Awareness of emergent tropical diseases is necessary due to evidence of demyelinating events and possible parainfectious cases of MS and NMOSD.
ISSN:0004-282X
1678-4227

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