Multiple Sclerosis is a multifaceted disease with major disagreement about its pathogenesis. This prompted us to introduce in the current issue of MSARD, the first in our ‘Controversies’ series (see below), and in the same vein, refer our readers to a review on MS genetics by Sawcer and colleagues in the July edition of Lancet Neurology (
Sawcer et al., 2014). Although no single gene mutation has been implicated in MS, the presence of now over 100 common MS variants (polymorphisms) is emphasized in support of a genetic contribution to MS. Most variants relate to the HLA and the immune system which is proposed as evidence supporting an immune-based disease. This conclusion does not exclude the possibility of an infectious etiology as both HLA and the immune system are intricately involved in our response to infectious agents. A novel concept is proposed – Insufficient Non-redundant Unnecessary Sufficient (INUS) which helps explain the plurality of causation when a mutation cannot be found. The authors admit that current variants account only for about 25% of heritability and propose a new concept, namely ‘phantom heritability’!
- Sawcer S.
- Franklin R.J.
- Ban M.
Multiple sclerosis genetics.
Lancet Neurol. 2014; 13: 700-709
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- Multiple sclerosis genetics.Lancet Neurol. 2014; 13: 700-709
© 2014 Published by Elsevier Inc.