All About Multiple Sclerosis

More MS news articles for June 2004

Pathogenesis of Multiple Sclerosis: The Eyes Only See What the Mind is Prepared to Comprehend

Excerpts from:
Volume 55, Issue 4 , Pages 455 - 457
Dr. Bruce Trapp
Cleveland Clinic

“….the mechanism by which the immune system is “tricked” into seeing myelin as foreign in MS patients has eluded the MS community. In fact, it is so elusive that the topic is rarely discussed.”

“Why then have we had such difficulty in identifying the causative agent in MS? Is it possible that the immune response in MS is secondary to a primary disease mechanism? The article by Barnett and Prineas in this issue of Annals raises this possibility.”

“This view of MS lesion formation proposes apoptotic oligodendrocyte death as the primary cause of inflammation in the MS brain…There appears to be little doubt that oligodendrocyte death is preceding inflammation in their lesions.”

“If the apoptotic hypothesis is correct, it will be important to determine if oligodendrocyte death is a cell autonomous event or driven by an external signal.”

“The MS community has tried for decades to fit MS into the experimental allergic encephalomyelitis box and when all is said and done, it just does not fit.”…..”It is time to ask ourselves if modeling all aspects of MS after EAE is justified or prudent.”

“Even if Barnett and Prineas are correct……an even more important issue is whether inflammatory demyelination is central to the pathogenesis of MS or is part of a cascade of adaptive immune responses that evolved as a critical component of tissue repair. There is a true missing link in our understanding of MS and we must be open to surprises.”

Copyright © 2004, American Neurological Association