Multiple sclerosis and its treatment

Multiple sclerosis (MS) is a common neurological disorder responsible for substantial neurological morbidity. Although it is considered to be an autoimmune demyelinating disease of the central nervous system (CNS), mediated by antigen-specific CD4+ T helper (Th1) T-cells, therapeutic strategies aimed at generalised immunosuppression have been disappointing. Recently, immunomodulatory therapies like interferon (IFN)-beta and glatiramer acetate have proved more effective. They reduce the rate and severity of clinical relapses and, in the case of IFN-beta, delay the rate of disease progression. Symptomatic therapies and rehabilitation, however, remain the mainstay of treatment for the majority of patients with MS. The immunopathogenesis of MS and its treatments, both disease modifying and symptomatic, are reviewed below.