Vaknin-Dembinsky Adi, Weiner Howard L
Center for Neurologic Diseases and Partners Multiple Sclerosis Center, 77 Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115 USA.
J Neurol Sci. 2007 Aug 15;259(1-2):90-4. doi: 10.1016/j.jns.2006.11.022. Epub 2007 May 23.
Multiple sclerosis is classified as an inflammatory cell-mediated autoimmune disease directed against central nervous system myelin. Different stages of disease appear to be related to different patterns of inflammation and changes on MRI. It is postulated that the lack of response to anti-inflammatory drugs in the secondary progressive stage relates to a neurodegenerative component that is immune independent. However, there is also evidence that the immune system itself is more abnormal in the secondary progressive phase according to a number of immune measures including dendritic cell function in the peripheral blood. Furthermore, neuropathologic studies suggest that there is inflammation in the brain of MS patients in the progressive stages in which inflammation takes a different form that includes a diffuse inflammatory process in the brain and activation of microglial cells. In summary, this implies that there may be different types of inflammation depending on the stage of MS with abnormalities in adaptive immunity playing an important role in the relapsing-remitting stage and innate immunity a more important role in the progressive stage.
多发性硬化症被归类为一种针对中枢神经系统髓鞘的炎症性细胞介导的自身免疫性疾病。疾病的不同阶段似乎与不同的炎症模式以及磁共振成像（MRI）上的变化有关。据推测，继发进展期对抗炎药物缺乏反应与免疫独立的神经退行性成分有关。然而，也有证据表明，根据包括外周血中树突状细胞功能在内的多项免疫指标，免疫系统本身在继发进展期更为异常。此外，神经病理学研究表明，在进展期的多发性硬化症患者大脑中存在炎症，其中炎症呈现出不同的形式，包括大脑中的弥漫性炎症过程和小胶质细胞的激活。总之，这意味着根据多发性硬化症的阶段可能存在不同类型的炎症，适应性免疫异常在复发缓解期起重要作用，而固有免疫在进展期起更重要的作用。
