Peter Sundström discussed the management of risk factors in MS, focussing on infectious agents, in particular EBV.

Based on his experience from HIV/AIDS patients, Lars Hagberg reviewed the management of treatment-induced infections in patients with T-cell depression.

Eero Rissanen reviewed microglial pathophysiology and explained how MR and PET imaging can evaluate microglial activation.

Due to the extensive use of vaccinations, even a small increased risk of MS or other acquired CNS demyelinating syndromes could have a significant effect on public health. Jette Lautrup Frederiksen presented a systematic literature study on the role of vaccines regarding the risk of MS development and MS relapse.

The hygiene hypothesis, suggesting that low exposure to pathogens early in life can increase the risk for immune-mediated diseases, may explain the increased incidence of allergy and autoimmune diseases in industrialized countries. As Marte Wendel-Haga could not attend the symposium due to illness, Elisabeth Celius gave the presentation.

Recent clinical and experimental studies indicate that MS develops as a consequence of failed interplay between genetic (‘nature’) and environmental (‘nurture’) factors. Hartmut Wekerle argued that MS is most probably an autoimmune disease that is kindled in the gut, before discussing nurture-centred ways to modulate the disease in experimental animal models.

Elisabeth Celius discussed relapse management and the risk of infections associated with disease-modifying therapy.

Jan Lycke presented early data on antiviral treatment in MS, providing insights into MS care prior to the DMT era.

Annette Bang Oturai outlined the possibilities of modifying gut microbiota composition.

Henrik Zetterberg reviewed fluid biomarkers for microglial activation and neuronal injury that may find use for investigating the relationship between infections and CNS diseases, focussing on astroglial markers and neurofilament light. He also presented a new assay for measuring neurofilament light in blood.