Multiple sclerosis: current pathophysiological concepts

被引:156
作者
Wingerchuk, DM
Lucchinetti, CF
Noseworthy, JH
机构
[1] Mayo Clin, Dept Neurol, Rochester, MN 55905 USA
[2] Mayo Clin, Dept Neurol, Scottsdale, AZ USA
关键词
D O I
10.1038/labinvest.3780235
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Multiple sclerosis (MS) is an often disabling disease primarily affecting young adults that exhibits extraordinary clinical, radiological. and pathological heterogeneity. We review the following: (a) known environmental and genetic factors that contribute to MS susceptibility; (b) current knowledge regarding fundamental pathophysiological processes in MS, including immune cell recruitment and entry into the central nervous system (CNS), formation of the plaque, and orchestration of the immune response; (c) descriptive and qualitative distinct pathological patterns in MS and their implications; (d) the evidence supporting the causative role of direct toxins, cell-mediated and humorally mediated immune mechanisms, and the concept of a "primary oligodendrogliopathy" in demyelination and axonal injury; (e) the potential benefits of inflammation; Q the prospects for remyelination; and (g) therapeutic implications and approaches suggested by putative pathophysiological mechanisms.
引用
收藏
页码:263 / 281
页数:19
相关论文
共 180 条
[91]  
Lucchinetti C, 2000, ANN NEUROL, V47, P707, DOI 10.1002/1531-8249(200006)47:6<707::AID-ANA3>3.0.CO
[92]  
2-Q
[93]   Distinct patterns of multiple sclerosis pathology indicates heterogeneity in pathogenesis [J].
Lucchinetti, CF ;
Bruck, W ;
Rodriguez, M ;
Lassmann, H .
BRAIN PATHOLOGY, 1996, 6 (03) :259-274
[94]   Chemokines - Chemotactic cytokines that mediate inflammation [J].
Luster, AD .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 338 (07) :436-445
[95]   Matrix metalloproteinases in the normal human central nervous system, microglial nodules, and multiple sclerosis lesions [J].
Maeda, A ;
Sobel, RA .
JOURNAL OF NEUROPATHOLOGY AND EXPERIMENTAL NEUROLOGY, 1996, 55 (03) :300-309
[96]   Proinflammatory cytokines regulate antigen independent T-cell activation by two separate calcium-signaling pathways in multiple sclerosis patients [J].
Martino, G ;
Grohovaz, F ;
Brambilla, E ;
Codazzi, F ;
Consiglio, A ;
Clementi, E ;
Filippi, M ;
Comi, G ;
Grimaldi, LME .
ANNALS OF NEUROLOGY, 1998, 43 (03) :340-349
[97]   Immunopathogenesis of multiple sclerosis: the role of T cells [J].
Martino, G ;
Hartung, HP .
CURRENT OPINION IN NEUROLOGY, 1999, 12 (03) :309-321
[98]   Transport of chemically active species in plasma reactors for etching [J].
Martisovits, V ;
Zahoran, M .
PLASMA SOURCES SCIENCE & TECHNOLOGY, 1997, 6 (03) :280-297
[99]   A very high level of crossreactivity is an essential feature of the T-cell receptor [J].
Mason, D .
IMMUNOLOGY TODAY, 1998, 19 (09) :395-404
[100]   Serum soluble adhesion molecules in multiple sclerosis: raised sVCAM-1, sICAM-1 and sE-selectin in primary progressive disease [J].
McDonnell, GV ;
McMillan, SA ;
Douglas, JP ;
Droogan, AG ;
Hawkins, SA .
JOURNAL OF NEUROLOGY, 1999, 246 (02) :87-92