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Semin Neurol 2016; 36(02): 115-127
DOI: 10.1055/s-0036-1579739
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Immunology of Multiple Sclerosis

Mireia Sospedra
1   Section of Neuroimmunology and MS Research, Neurology Clinic, University Hospital Zurich, University of Zurich, Zurich, Switzerland
,
Roland Martin
1   Section of Neuroimmunology and MS Research, Neurology Clinic, University Hospital Zurich, University of Zurich, Zurich, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
26 April 2016 (online)

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Abstract

Multiple sclerosis (MS) is considered a prototypic autoimmune disease of the central nervous system (CNS). A complex genetic background with the HLA-DR15 haplotype as the main genetic risk factor and over 100 mostly immune-related minor risk alleles as well as several environmental factors contribute to the etiology of MS. With respect to pathomechanisms, autoimmune inflammation in early MS is primarily mediated by adaptive immune responses and involves autoreactive T cells, B cells, and antibodies, while the later, chronic stages of MS are characterized by a compartmentalized immune response in the CNS with activated microglia and macrophages. A host of immune cells and mediators can contribute to the autoimmune process, but CNS-related factors such as localization of lesions, vulnerability of oligodendrocytes, neurons/axons, and secondary metabolic changes all play a role in the heterogeneous expression of the disease, including different pathologic lesion patterns, neuroimaging findings, disease courses, and severity and response to treatment.

Keywords

multiple sclerosis - immunology - adaptive immunity - pathomechanisms - T cells - antibodies - B cells
 

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