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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
09:41

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Published on: July 19, 2019

Progressive multiple sclerosis: pathology and pathogenesis.

Hans Lassmann1, Jack van Horssen, Don Mahad

  • 1Centre for Brain Research, Medical University of Vienna, Wien, Austria. hans.lassmann@meduniwien.ac.at

Nature Reviews. Neurology
|September 26, 2012
PubMed
Summary
This summary is machine-generated.

Effective treatments exist for relapsing-remitting multiple sclerosis (MS), but progressive MS pathogenesis remains challenging. Inflammation behind the blood-brain barrier and oxidative stress contribute to neurodegeneration in MS.

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Area of Science:

  • Neuroscience
  • Immunology
  • Pathology

Background:

  • Significant advancements in understanding multiple sclerosis (MS) inflammation and pathogenesis over three decades.
  • Effective anti-inflammatory and immunomodulatory treatments are available for relapsing-remitting MS.

Purpose of the Study:

  • To review the pathology of progressive MS.
  • To discuss new data on the mechanisms underlying progressive MS pathogenesis.

Main Methods:

  • Literature review of studies on MS pathology and pathogenesis.
  • Analysis of recent data on inflammatory responses and oxidative stress in MS.

Main Results:

  • Active tissue injury in progressive MS involves inflammation, often occurring behind the blood-brain barrier, complicating treatment.
  • Oxidative stress and mitochondrial injury may drive demyelination and neurodegeneration in both relapsing-remitting and progressive MS.
  • Microglial oxidative burst contributes to oxidative stress, potentially amplified in progressive MS by iron accumulation and mitochondrial gene deletions.

Conclusions:

  • While treatments for relapsing-remitting MS are effective, progressive MS pathogenesis requires further elucidation.
  • Targeting inflammation behind the blood-brain barrier and mitigating oxidative stress are potential therapeutic avenues for progressive MS.