The mysteries of multiple sclerosis

MSMultiple sclerosis (MS) is a chronic, progressive demyelinating disease of the central nervous system. The incidence in Northen Europe and North America is 1 :1000 individuals. The relapsing-remitting form is the most frequent and it develops with recurrent episodes of neurological attacks followed by at least partial recovery.
Multiple perivascular inflammatory foci take place in the brain of MS patient, especially with periventricular distribution. These foci consist of infiltrating T-cells and monocytes. MS is hypothesized to be primarily a T-helper cell-mediated autoimmune disease. However, CD8 T, natural killer cells, B cells and regulatory B cells, microglia, macrophages, astrocytes, a great numbers of pro-inflamamtory and anti-inflammatory cytokines and adhesion molecules are involved. According to the autoimmune hypothesis of MS pathogenesis, T cells reactive to CNS proteins (such as myelin basic protein and myelin oligodendrocyte glycoprotein among many others) must first be activated in the body outside the brain before they gain the potential to cause damage within the CNS. What it is the cause of this activation is still one of the great mysteries of neurology. It would be fundamental to know the blood biomarkers that precedes the relapsing phases. Remission could be the result of an apoptosis of activated lymphocytes. Multiple Sclerosis reserves many other mysteries.

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