[The rational basis of the newer treatments used in multiple sclerosis].

INTRODUCTION

Multiple sclerosis is a disease known as a clinicopathological entity since more than a century, but its ethiology remains unknown till today.

OBJECTIVE

In this paper the pathogenic mechanisms of this disease are reviewed; this knowledge has permitted and will permit in the very next future to develop new treatments more efficacious.

DEVELOPMENT

All the knowledge from the different areas related to multiple sclerosis, neuropathology, neuroimaging, genetics, epidemiology, virology and immunology, are reviewed and integrated. The integration of all these information has permitted to elaborate a pathogenic hypothesis, according to which, multiple sclerosis most probably is an autoimmune disease, that will affect persons with genetic susceptibility after exposition to one or more environmental agents, being unknown the responsible antigen, most probable one or more viruses. The new treatments, although not aiming to the causal agent, intend to interfere with some links involved in the pathogenesis of the disease, attempting to slow the progression, if not to cure the disease.

CONCLUSIONS

Today, is possible to approach the development of new treatments of multiple sclerosis with a scientific basis, although the ethiology is unknown and undoubtedly the pathogenic hypothesis is incomplete.