This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
The cause and exact processes underlying the pathophysiology of multiple sclerosis (MS) development and progression have eluded clinicians and scientists for almost 150 years, since Jean-Martin Charcot recognized it as a distinct disease. Based on current understanding, an inflammatory immune response, potentially elicited by a common pathogen or unidentified microbial or environmental agent, is inappropriately targeted against CNS components, possibly a myelin protein, and not properly tempered by immune regulatory circuits. Blood-derived T and B cells are critical components of the adaptive immune response that initiates the inflammatory attack, although innate immunity is also implicated, with macrophages and microglia operating as antigen presenting cells, as demyelinating effector cells, and possibly as mediators of a diffuse chronic CNS inflammatory state.
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the author, if any, are provided at the end of the editorial.
See page 981
- © 2015 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Disputes & Debates: Rapid online correspondence
NOTE: All authors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.
- Stay timely. Submit only on articles published within the last 8 weeks.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- 200 words maximum.
- 5 references maximum. Reference 1 must be the article on which you are commenting.
- 5 authors maximum. Exception: replies can include all original authors of the article.
- Submitted comments are subject to editing and editor review prior to posting.