title: [Multiple sclerosis: current immunological aspects].
abstract: Multiple sclerosis is the most common inflammatory, chronic and degenerative condition of the central nervous system, and represents the first cause of disability in young adults. In Mexico, 11 to 20 out of every 100 000 people suffer from this disease. The causes of multiple sclerosis remain unknown, but several theories have been proposed: the interaction of environmental factors, viral infectious factors and genetic and immune susceptibility of each individual patient, which induce an autoimmune response and promote neuronal/axonal degeneration. In this review, the immune reaction main components and neurodegeneration present in multiple sclerosis are analyzed, as well as the inflammatory cascade associated with demyelination. Available treatments' main purpose is to modulate aspects related to the adaptive immune response (B and T cells). The therapeutic challenge will be antigen-specific immune-tolerance induction, for example, with the use of tolerance protocols with peptides or DNA or nanoparticles vaccines. Future therapies should aim to control innate components (microglia, macrophages, astrocytes) and to promote remyelination. To optimize the treatment, a combined therapeutic approach targeting the control of inflammatory and neurodegenerative components of the disease and monitoring of biomarkers will be necessary.
authors.affiliation: Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades, Dirección General, Ciudad de México, México. cacu61152@hotmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Cuevas-García
mesh_terms: D056704:Adaptive Immunity; D001253:Astrocytes / Q000276:immunology; D001369:Axons / Q000473:pathology; D003131:Combined Modality Therapy; D003711:Demyelinating Diseases; D005979:Glutathione Peroxidase / Q000502:physiology; D006801:Humans; D007113:Immunity, Innate; D007167:Immunotherapy / Q000379:methods; D007249:Inflammation; D016131:Lymphocyte Subsets / Q000276:immunology; D008264:Macrophages / Q000276:immunology; D008800:Mexico / Q000453:epidemiology; D017628:Microglia / Q000276:immunology; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000209:etiology / Q000276:immunology* / Q000628:therapy; D009410:Nerve Degeneration; D018384:Oxidative Stress
chemical_list: D005979:Glutathione Peroxidase
keywords: Adaptive immune response; Central nervous system diseases; Multiple sclerosis