engleski

Pathophysiology of multiple sclerosis

Understanding of the pathophysiology of multiple sclerosis (MS) provides an explanation of the characteristic features of the disease and has implications on therapeutic strategies. MS is considered to be inflammatory disease of the central nervous system (CNS) with a pathological picture of extensive demyelination and relative preservation of axons. Nevertheless, axons are lost in almost all lesions, in some of them extensively. In all lesions there is astrocytic gliosis. Therefore, MS is now believed to involve a biphasic disease process. Early, inflammation is prominent, corresponding to the relapsing and potentially reversible phase of MS. Later, there is transition to a primarily neurodegenerative phase, corresponding to progressive MS with irreversible deficits. Although inflammation and neurodegeneration are detected at all time points, one process appears to dominate. This is transition between three stages, episodes of full recovery, persistent deficit and secondary progression which is usually gradual and indistinct making many intermediate forms of the disease. The great variability of MS represents in fact an externally observable part of an underlying essentialy continuous process with complex pathophysiologic changes.

multiple sclerosis; pathophysiology; inflammation; neurodegeneration

nije evidentirano