title: Current multiple sclerosis treatments have improved our understanding of MS autoimmune pathogenesis.
abstract: Multiple sclerosis (MS) is the most common inflammatory disorder of the central nervous system (CNS) in young adults. When MS is not treated, it leads to irreversible and severe disability. The etiology of MS and its pathogenesis are not fully understood. The recent discovery that MS-associated genetic variants code for molecules related to the function of specific immune cell subsets is consistent with the concept of MS as a prototypic, T-cell-mediated autoimmune disease targeting the CNS. While the therapeutic efficacy of the currently available immunomodulatory therapies further strengthen this concept, differences observed in responses to MS treatment as well as additional clinical and imaging observations have also shown that the autoimmune pathogenesis underlying MS is much more complex than previously thought. There is therefore an unmet need for continued detailed phenotypic and functional analysis of disease-relevant adaptive immune cells and tissues directly derived from MS patients to unravel the immune etiology of MS in its entire complexity. In this review, we will discuss the currently available MS treatment options and approved drugs, including how they have contributed to the understanding of the immune pathology of this autoimmune disease.
authors.affiliation: Neuroimmunology and Multiple Sclerosis Research Section, Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: Martin
authors.affiliation: Neuroimmunology and Multiple Sclerosis Research Section, Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Mireia
authors.initials: M
authors.lastname: Sospedra
authors.affiliation: Theodor Kocher Institute, University of Bern, Bern, Switzerland.
authors.forename: Maria
authors.initials: M
authors.lastname: Rosito
authors.affiliation: Theodor Kocher Institute, University of Bern, Bern, Switzerland. bengel@tki.unibe.ch.
authors.forename: Britta
authors.initials: B
authors.lastname: Engelhardt
mesh_terms: D000818:Animals; D001327:Autoimmune Diseases / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D015551:Autoimmunity; D015415:Biomarkers; D002490:Central Nervous System / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007113:Immunity, Innate; D058990:Molecular Targeted Therapy; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000628:therapy*; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism
chemical_list: D015415:Biomarkers
keywords: Autoantibodies; Autoimmune pathogenesis; Autoimmunity; Autoreactive B cells; Autoreactive T cells; Experimental autoimmune encephalomyelitis; Multiple sclerosis; Treatment