title: Immunology of multiple sclerosis.
abstract: Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) leading to demyelination, axonal damage, and progressive neurologic disability. The development of MS is influenced by environmental factors, particularly the Epstein-Barr virus (EBV), and genetic factors, which include specific HLA types, particularly DRB1*1501-DQA1*0102-DQB1*0602, and a predisposition to autoimmunity in general. MS patients have increased circulating T-cell and antibody reactivity to myelin proteins and gangliosides. It is proposed that the role of EBV is to infect autoreactive B cells that then seed the CNS and promote the survival of autoreactive T cells there. It is also proposed that the clinical attacks of relapsing-remitting MS are orchestrated by myelin-reactive T cells entering the white matter of the CNS from the blood, and that the progressive disability in primary and secondary progressive MS is caused by the action of autoantibodies produced in the CNS by -meningeal lymphoid follicles with germinal centers.
authors.affiliation: Neuroimmunology Research Centre, Clinical Sciences Building, Royal Brisbane and Womens Hospital, Herston, Queensland 4029, Australia. m.hawes@uq.edu.au
authors.forename: Michael P
authors.initials: MP
authors.lastname: Pender
authors.forename: Judith M
authors.initials: JM
authors.lastname: Greer
mesh_terms: D001323:Autoantibodies / Q000276:immunology; D001369:Axons / Q000276:immunology / Q000473:pathology; D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology; D002490:Central Nervous System / Q000276:immunology* / Q000473:pathology; D002908:Chronic Disease; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000235:genetics / Q000276:immunology*; D005260:Female; D005732:Gangliosides / Q000276:immunology; D020022:Genetic Predisposition to Disease; D006681:HLA-D Antigens / Q000235:genetics / Q000276:immunology*; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000209:etiology / Q000235:genetics / Q000276:immunology* / Q000473:pathology; D009185:Myelin Proteins / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology
chemical_list: D001323:Autoantibodies; D005732:Gangliosides; D006681:HLA-D Antigens; D009185:Myelin Proteins