Current perspectives on the pathogenesis of multiple sclerosis: A minireview

Area of Science:

• Neuroimmunology
• Vascular Biology
• Metabolic Syndrome

Background:

• Multiple sclerosis (MS) is a chronic, immune-mediated central nervous system disease causing disability.
• Its pathogenesis is multifactorial, involving genetic, immune, and environmental factors.
• Early disease mechanisms are crucial for understanding MS progression before treatment effects.

Purpose of the Study:

• To review early vascular and metabolic alterations in newly diagnosed multiple sclerosis.
• To explore the role of lipoprotein subfractions, endothelial dysfunction, and autonomic imbalance.
• To investigate insulin sensitivity, inflammation, and oxidative damage in early MS.

Main Methods:

• Mini-review of recent research on early vascular and metabolic changes in MS.
• Analysis of lipoprotein profiles, endothelial function, and autonomic nervous system activity.
• Examination of metabolic changes, oxidative damage, and antioxidant capacity.

Main Results:

• Early MS shows vascular changes like endothelial dysfunction and accelerated vascular aging.
• Metabolic alterations include impaired insulin sensitivity and changes in lipoprotein subfractions.
• Oxidative damage and reduced antioxidant capacity are evident, contributing to tissue injury.

Conclusions:

• Vascular and metabolic dysregulation are significant early contributors to multiple sclerosis pathogenesis.
• Endothelial dysfunction and altered metabolic profiles may precede significant disability.
• Interventions targeting vascular and metabolic health could be beneficial in early MS management.