Multiple Sclerosis and Other Demyelinating Diseases

Multiple sclerosis (MS) is the most common idiopathic demyelinating disease of the central nervous system (CNS). Although partially effective treatments are now available, MS represents a major target for research into the development of disease-modifying therapies that specifically focus on the neuroimmune pathways of myelin and tissue damage that currently are incompletely understood. Multiple sclerosis is considered to be an example of development of autoimmunity to self-antigens within the CNS through multiple initiating events that include infections and other environmental factors. The direct or indirect induction of immune responses against CNS antigens includes chemotaxis of T cells, B cells, and monocytes, and production of immunoglobulin responses, each of which can act as an effector of myelin damage that occurs in distinct histological patterns. Because a specific cause for MS has not been identified, much MS research has focused on CNS immune responses triggered by unidentified insults that in turn trigger inflammation-mediated cascades of myelin and cellular damage that are likely relevant to other neurodegenerative diseases. This chapter discusses current the epidemiology, etiology, pathophysiology, animal models, virus models and recent advances in the neuroimmunology of MS from the perspective of the potential for development of newer therapies for MS and other inflammatory CNS diseases.