J Allergy Clin Immunol. 2003 Nov;112(5):837-49
Chitnis T, Khoury SJ.
Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, USA.
Multiple sclerosis is an immune-mediated disorder of the central nervous system.
T lymphocytes are thought to play a central role in the initiation and potentially in the propagation of this disease.
Two signals are required for T-cell activation.
The first signal consists of the interaction of the T-cell receptor with antigen presented by the MHC molecule on antigen-presenting cells.
The second signal requires engagement of costimulatory receptors on T cells with their ligands on antigen-presenting cells.
Several costimulatory pathways have been shown to play an important role in T-lymphocyte activation.
Here we will review the current literature on the contribution of the B7-1/2-CD28/CTLA-4, inducible costimulatory molecule-B7h, programmed death pathway 1-programmed death pathway ligand 1/ligand 2, CD40-CD154, OX40-OX40 ligand, and CD137-CD137 ligand pathways to the pathogenesis of multiple sclerosis and their potential roles as therapeutic targets.