Multiple Sclerosis and the Immune System

Abstract
Multiple sclerosis (MS), although described more than 100 years ago, remains an etiologic and therapeutic enigma despite massive research attention stimulated in large part by the National Multiple Sclerosis Society. In view of the effort invested in studies of MS, relatively few repeatedly confirmed facts are known about the disease. The variable clinical pattern, with remitting disease in young adult life and progressive disease later on, is well known; and there is little doubt that it is a disease found primarily in temperate areas of the world, occurring more commonly in white patients and in women. Epidemiologic and tissue antigen studies strongly suggest that MS has a genetic component.1Nevertheless studies of migrating populations also strongly suggest an environmental factor,2and even the likelihood that MS may occur in epidemic form.3 Pathologically, the primary destruction of CNS myelin in focal plaques is universally appreciated; however, less is

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