Multiple Sclerosis Neurobiology and Therapeutic Strategies

Multiple Sclerosis Neurobiology and Therapeutic Strategies

Publication date: Oct 11, 2019

Multiple sclerosis (MS) is an autoimmune, acquired T cell-mediated neuro-inflammatory disorder that is marked by axonal degeneration and focal demyelination in the central nervous system (CNS).

In around 10% of patients, the disease is progressive, marked by the slow development of disability from onset.

Figure 1: Mechanisms of demyelination and axon degeneration in MS. The pathological characteristics of MS are demyelination, neuroinflammation, and axonal degeneration.

T2 weighted axial view of MRI brain scan from a patient with relapsing-remitting MS. Multiple white matter T2 hyperintense lesions are shown, in orientation and distribution typical for MS. Since 1865, when MS was first defined by Charcot, researchers and clinicians have considered the risk factors for developing MS. There is evidence of a polygenetic determinant of risk; specific human leukocyte antigen haplotypes bestow higher susceptibility.

Exposure to Epstein Barr virus over the course of an age-linked period of susceptibility is an environmental risk factor for MS. Furthermore, low vitamin D levels are associated with risk of relapse, and studies are evaluating whether vitamin D replacement impacts MS disease course.

The concept of disease activity is vital to the understanding of an inflammatory basis for MS relapses.

MR imaging with the potential to show subclinical CNS inflammation is a powerful tool in the measurement of disease activity (see Figure 3).

In addition, loss of CNS volume (atrophy), estimated between interval scans, is also associated with the slow accrual of disability in progressive disease.

In order to evaluate potential treatment effects on progressive disease, it is vital to measure disability.

Several licensed drug treatments are available for relapsing-remitting MS. These treatments minimize the burden of relapse.

Although there has been progress, no significant randomized control trial evidence is available to indicate that any of these treatments have a considerable effect on long-term disability.

Concepts Keywords
Action Potentials EDSS
Adenine Multiple sclerosis research
Adverse Event Magnetic resonance imaging
Anion Tomography
Antigen Antibodies
Antigens MRI
Atrophy Relapsing–remitting
Autoimmune Demyelinating disease
Axon Myelin
Axonal Transport Medicine
Blood Brain Barrier Multiple sclerosis
Brain Organ systems
Catalase Nervous system
Central Nervous System MS
Cerebrospinal Fluid Pathological characteristics demyelination
Clinical Trials Demyelination Axonal injury
Cognition Disease
Demyelination CNS inflammation
Determinant Customers highest products
Detoxification
Disability
Division
DR2
Enzyme
Epstein Barr Virus
Equator
Fluorescent
Frequency
Genetic
Gradient
Haplotypes
HLA
Immunomodulatory
Inflammation
Interferon
Ion Channel
Latitude
Latitudinal
Leukocyte
Magnetic Resonance Imaging
Molecular Oxygen
Monoclonal Antibodies
Motor System
MRI
MRI Brain Scan
Multiple Sclerosis
Myelin
NADPH
Neurological
Nicotinamide
Nitric Oxide
NOS
Oligodendrocytes
Oxidase
Oxygen
Peroxidases
Phosphate
Progressive
Randomized Control Trial
Receptor
Relapse
Respiratory Burst
Risk Factor
ROS
Spinal Cord
Superoxide
Techne
Tolerability
Tomography
Toxicity
United Brands
United Kingdom
Viral
Vitamin
White Matter

Semantics

Type Source Name
drug DRUGBANK Meclofenamic acid
gene UNIPROT ELK3
gene UNIPROT EPHB1
gene UNIPROT SLC6A2
drug DRUGBANK Coenzyme M
disease MESH community
drug DRUGBANK Dimethyl fumarate
drug DRUGBANK Teriflunomide
disease MESH atrophy
disease MESH inflammation
drug DRUGBANK Vitamin D
disease MESH viral infections
drug DRUGBANK Tropicamide
drug DRUGBANK Flunarizine
disease MESH risk factors
disease DOID relapsing-remitting MS
gene UNIPROT CAT
drug DRUGBANK Water
gene UNIPROT NOS2
drug DRUGBANK Nitric Oxide
drug DRUGBANK Phosphate ion
drug DRUGBANK Nadide
drug DRUGBANK Oxygen
gene UNIPROT ROS1
gene UNIPROT CYREN
disease MESH Diagnosis
disease MESH development
disease MESH relapses
disease MESH demyelination
disease DOID Multiple Sclerosis
disease MESH Multiple Sclerosis

Original Article

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