Poser C M
Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, 02215, Boston, MA, USA.
Clin Neurol Neurosurg. 2000 Dec;102(4):191-194. doi: 10.1016/s0303-8467(00)00101-3.
A series of recently published articles by a group of Austrian, German and American neuropathologists have proposed the existence of several different pathogenetic pathways in multiple sclerosis (MS). These studies were based on both biopsy and autopsy material. A review of the available published clinical, imaging and cerebrospinal fluid data suggest that some the cases used in those studies were more probably instances of disseminated encephalomyelitis rather than MS. This has serious implications regarding the specificity and significance of the findings in regard to MS pathogenesis. The specific myelinoclastic sequence and the variable clinical course of MS are determined by the individual's genetic endowment and immunologic history. Regardless of pathogenetic pathway and clinical course, the final pathologic picture of MS is always the same. The MS brain is genetically programmed to produce a unique, pathognomonic change, the plaque with sharply demarcated borders.
一组奥地利、德国和美国神经病理学家最近发表的一系列文章提出，多发性硬化症（MS）存在几种不同的致病途径。这些研究基于活检和尸检材料。对已发表的现有临床、影像学和脑脊液数据的回顾表明，那些研究中使用的一些病例更可能是播散性脑脊髓炎而非MS的实例。这对于MS发病机制研究结果的特异性和意义具有严重影响。MS特定的髓鞘破坏序列和多变的临床病程由个体的遗传禀赋和免疫史决定。无论致病途径和临床病程如何，MS的最终病理表现总是相同的。MS大脑在基因上被设定会产生一种独特的、具有诊断意义的变化，即边界清晰的斑块。
