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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
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Axonal loss in multiple sclerosis: causes and mechanisms.
Gerson Criste1, Bruce Trapp1, Ranjan Dutta1
1Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Handbook of Clinical Neurology
|February 11, 2014
Summary
Multiple sclerosis (MS) causes irreversible neurologic decline due to axonal loss. Understanding these mechanisms is crucial for developing new therapies to halt disease progression.
Area of Science:
- Neuroscience
- Immunology
- Pathology
Background:
- Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
- It is a leading cause of non-traumatic neurologic disability in young adults in the US and Europe.
- Axonal and neuronal loss drives progressive neurologic decline in MS, particularly after compensatory capacity is surpassed.
Purpose of the Study:
- To review existing data on the mechanisms of axonal pathology in MS.
- To highlight the importance of understanding axonal loss for developing new therapies.
- To discuss the transition from reversible episodes to irreversible decline in MS.
Main Methods:
- Review of existing literature on MS pathology.
- Analysis of current hypotheses regarding axonal loss mechanisms.
- Synthesis of data on inflammatory demyelination and neuronal damage.
Main Results:
- Primary inflammatory demyelination is hypothesized to cause early axonal loss in MS.
- A threshold of neuronal and axonal loss may trigger the transition to a progressive disease course.
- Current immunomodulatory therapies are less effective once irreversible decline begins.
Conclusions:
- Elucidating mechanisms of axonal loss is essential for effective MS therapies.
- Targeting axonal pathology could halt or slow progressive neurologic decline.
- Further research into the underlying causes of axonal damage is critical for MS patient outcomes.
Keywords:
axonal degenerationaxonal transectionaxonsdemyelinationinjurymyelinmyelin proteinsneuroprotectionMore Related Videos
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