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Br Med Bull 1997 Jan;53(1):24-39

Infection in childhood and neurological diseases in adult life.

Martyn CN
MRC Environmental Epidemiology Unit, Southampton General Hospital, UK.

Other chapters in this issue discuss the evidence that implicates infection
during infancy and childhood in the etiology of respiratory disease. Here I
argue that experience of infection in early life may also be involved in the
aetiology of some diseases of the adult nervous system. The descriptive
epidemiology of three neurological diseases is compatible with the
hypothesis that they are delayed consequences of childhood infection. It is
not difficult to imagine that the effects of an infection which results in
loss of cells from an organ system, like the central nervous system, whose
cell populations have lost the capacity to replace themselves by mitotic
division could remain hidden until unmasked by ageing. Such a mechanism may
be important in the aetiology of motor neuron disease and Parkinson's
disease. Age-related differences in host response, which may be partly
related to a maturing immune system, are known to influence both short- and
long-term outcome for several infections. Perhaps the immune response to
infection with Epstein-Barr virus, or another common micro-organism with
similar epidemiology, in adolescence or early adult life is sometimes
directed at antigens that are also present in the central nervous system. At
present, the evidence that supports these hypotheses is largely
circumstantial. But it may be possible to devise ways of testing them both
epidemiologically and in the laboratory.