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Wie bei den meisten Autoimmunkrankheiten scheinen eine genetische Pra-disposition und Umweltfaktoren notwendig zu sein, damit eine multiple Sklerose entstehen kann. Ungewiss bleibt jedoch, wie stark sich die genannten Faktoren jeweils auswirken. Auf die Bedeutung der genetischen Faktoren wurde bereits vor uber hundert Jahren hingewiesen, als Eichhorst die multiple Sklerose als eine genetisch bedingte und vererbbare Krankheit identifizierte, nachdem er zwei mehrfach betroffene Familien [1] beobachtet hatte. Seit dem ersten Viertel des 20. Jahrhunderts wurde eine Fulle epidemiologischer Studien durchgefuhrt, die das Vorhandensein zahlreicher Unterschiede in der Verteilung der Krankheit auf einzelne Lander und Populationen sowie innerhalb eben dieser Populationen je nach dem Wohnort oder dem Alter zur Zeit eines Ortswechsels in breitem Umfang belegten. Die Verwendung von Tiermodellen, die Untersuchung anderer multifaktorieller Krankheiten mit komplexer genetischer Ubertragung, die Fortschritte der Populationsgenetik haben nachhaltig klar gemacht, dass die Beziehung zwischen dem genetischen Erbe und der Umwelt nicht so leicht gedeutet werden kann. So drangt sich der Gedanke auf, dass die multiple Sklerose geographisch ungleich verteilt ist, doch spiegelt dies fur die einen das Vorhandensein eines infektiosen Agens, fur die anderen hingegen den Einfluss eines Gens wider.

Both genetic and environmental factors play a role in the pathophysiology of MS and may influence the clinical expression of the disease.To determine the contribution of familial factors to the clinical expression of MS.The French Multiple Sclerosis Genetics Group identified 87 sibling pairs. For each patient, sex, age at onset, duration of the disease, and disease course from onset were recorded. Disability was determined by the progression index (PI), defined as the ratio of the Expanded Disability Status Scale (EDSS) score disease duration when the latter exceeded 5 years. Statistical analyses were performed either with a group of patients (clinical features, relation between human leukocyte antigen and clinical features) or with a group of sibpairs (concordance for clinical features).The mean age at onset was 29.6 years, the ratio of women to men was 59:28, and the mean PI was 0.27. There was no correlation for disease course and age at onset between sibs with MS. In contrast, we observed a weak but significant correlation of the PI in MS sibpairs (r = 0.234, p = 0.03).This study revealed a concordance in MS sibling pairs for the disease severity, supporting the hypothesis that the degree of disability might be partly influenced by familial factors (environmental or genetic).

Background: Both genetic and environmental factors play a role in the pathophysiology of MS and may influence the clinical expression of the disease.Objective: To determine the contribution of familial factors to the clinical expression of MS.Methods: The French Multiple Sclerosis Genetics Group identified 87 sibling pairs. For each patient, sex, age at onset, duration of the disease, and disease course from onset were recorded. Disability was determined by the progression index (PI), defined as the ratio of the Expanded Disability Status Scale (EDSS) score disease duration when the latter exceeded 5 years. Statistical analyses were performed either with a group of patients (clinical features, relation between human leukocyte antigen and clinical features) or with a group of sibpairs (concordance for clinical features).Results: The mean age at onset was 29.6 years, the ratio of women to men was 59:28, and the mean PI was 0.27. There was no correlation for disease course and age at onset between sibs with MS. In contrast, we observed a weak but significant correlation of the PI in MS sibpairs (r = 0.234, p = 0.03).Conclusion: This study revealed a concordance in MS sibling pairs for the disease severity, supporting the hypothesis that the degree of disability might be partly influenced by familial factors (environmental or genetic).