Infektionen und Multiple Sklerose

Felicita Heidler; Tobias Bopp; Matthias Schwab; Frank A Hoffmann; Hansjörg Schild; Martina Kannler; Mathias Pletz; Uwe K. Zettl

doi:10.1055/a-2283-7401

Fortschritte der Neurologie · Psychiatrie, Inhaltsverzeichnis

Fortschr Neurol Psychiatr 2025; 93(07/08): 289-305
DOI: 10.1055/a-2283-7401

Übersichtsarbeit

Infektionen und Multiple Sklerose

Infections and multiple sclerosis

Felicita Heidler

¹Klinik für Neurologie, ökumenisches Hainich Klinikum gGmbH. Mühlhausen, Germany (Ringgold ID: RIN27189)

,

Tobias Bopp

²Institut für Immunologie, Universität Mainz Klinikum, Mainz, Germany, Johannes Gutenberg Universität Mainz Klinikum, Mainz, Germany (Ringgold ID: RIN39068)

,

Matthias Schwab

³Klinik für Neurologie, Universitätsklinikum Jena, Jena, Germany (Ringgold ID: RIN39065)

,

Frank A Hoffmann

⁴Klinik für Neurologie mit stroke unit MS-Zentrum, Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle, Germany (Ringgold ID: RIN89533)

,

Hansjörg Schild

⁵Institut für Immunologie, Johannes Gutenberg Universität Mainz Klinikum, Mainz, Germany (Ringgold ID: RIN39068)

,

Martina Kannler

⁶Medical Affairs Neurologie, Janssen-Cilag GmbH, Neuss, Germany (Ringgold ID: RIN60853)

,

Mathias Pletz

⁷Institut für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Jena, Germany (Ringgold ID: RIN39065)

,

Uwe K. Zettl

⁸Klinik und Poliklinik für Neurologie, Zentrum für Nervenheilkunde, Universitätsmedizin Rostock, Rostock, Germany (Ringgold ID: RIN39071)

› Institutsangaben

Abstract

Zusammenfassung

In der Studienliteratur nehmen die Ursachen, Bedingungen und Folgen von Infektionen bei Patienten mit einer Multiplen Sklerose (MS) nicht den Platz ein, der ihnen von der Alltagsrelevanz her zustünde. Gerade Harnwegsinfekte und vor allem Pneumonien tragen erheblich zu Krankenhauseinweisungen, Morbidität und Mortalität bei. In dieser Übersicht werden die aktuellen Erkenntnisse zu den Infektionskrankheiten einschließlich SARS-CoV-2 bei der MS zusammengefasst. Dabei geht es um drei Fragestellungen: Beeinflussen Infektionen das MS-Risiko? Wirken sich Infektionen auf die Krankheitsaktivität bei der MS aus? Welche Effekte haben die verschiedenen immunmodulatorischen MS-Therapien auf das Risiko und den Verlauf von Infektionskrankheiten? Um die Beratung und Versorgung der MS-Patienten zu verbessern, werden die Studienlage und aktuelle Empfehlungen überprüft und erörtert, was im Behandlungsalltag zu beachten ist.

Abstract

In the literature, causes, conditions, and consequences of infections in patients with multiple sclerosis (MS) have not received the attention they deserve in terms of the daily routine. In particular, urinary tract infections and especially pneumonia contribute significantly to hospitalizations, morbidity, and mortality. This review summarizes the current evidence on infectious diseases, including SARS-CoV-2, of multiple sclerosis (MS) patients. Three questions will be addressed: Do infections affect the risk for MS? Do infections affect the disease activity in MS? What are the effects of various immunomodulatory MS therapies on the infectious disease risk and disease progression? To improve primary care of MS patients, the study situation and current recommendations will be reviewed. Factors that need to be taken into consideration in daily treatment will be discussed.

Schlüsselwörter

Infektionen - Multiple Sklerose - Systemischer Überblick - immunmodulatorische MS Therapie

Keywords

infections - multiple sclerosis - systemic overview - immunomodulatory MS therapies - infectiology

Volltext

Referenzen

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