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The common view in the field of multiple sclerosis (MS) is that immune-mediated attacks of the CNS reflect some imbalance between effector and regulatory limbs of the immune system. Studies in adults with established MS point to exaggerated responses of effector cells (including Th1 and Th17 CD4 T cells, CD8 T cells) as well as defective suppressive capacities of regulatory cells (including Treg and Breg cells). Traditionally, the focus has been on memory (or “antigen-experienced”) cells, given the premise that the offending immune cells have already been activated to recognize CNS targets. However, it remains unclear whether the abnormalities in effector or regulatory cells emerge after immune cells are activated, or reflect the consequences of a primary defect in development of naive immune cells that have not yet encountered their antigen.
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- © 2013 American Academy of Neurology
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