Jeffery D R
Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Mult Scler. 2007 Sep;13(8):1071-5. doi: 10.1177/1352458507076981. Epub 2007 Jul 10.
Multiple sclerosis (MS) is thought to be an autoimmune disease in which activated T-cells initiate a macrophage mediated destruction of CNS myelin. Bone marrow transplantation (BMT) is currently being evaluated in the treatment of MS in patients with aggressive disease activity. Autologous BMT could potentially reset the immune response to myelin antigens leading to immune tolerance and decreased disease activity. Allogeneic transplantation could reconstitute the immune system potentially arresting the progression of autoimmune disease. The purpose of this paper is to report a patient with MS who underwent allogeneic BMT for chronic myelogenous leukemia (CML) and showed continued evidence of active demyelinating disease by clinical and radiologic criteria over a period of two years. While this is only a single case report with inherent limitations, it suggests that the immune mediated destruction of CNS myelin in MS may not be prevented or aborted by immune system reconstitution, and is consistent with the idea that immune mediated tissue destruction in MS could be targeted against an abnormal antigen.
多发性硬化症（MS）被认为是一种自身免疫性疾病，其中活化的T细胞引发巨噬细胞介导的中枢神经系统髓鞘破坏。目前正在评估骨髓移植（BMT）对疾病活动度高的MS患者的治疗效果。自体BMT可能会重置对髓鞘抗原的免疫反应，从而导致免疫耐受并降低疾病活动度。异基因移植可以重建免疫系统，有可能阻止自身免疫性疾病的进展。本文的目的是报告一名患有MS的患者，该患者因慢性粒细胞白血病（CML）接受了异基因BMT，并且在两年的时间里，通过临床和放射学标准持续显示出活动性脱髓鞘疾病的证据。虽然这只是一份存在固有局限性的单病例报告，但它表明MS中中枢神经系统髓鞘的免疫介导破坏可能无法通过免疫系统重建来预防或中止，并且与MS中免疫介导的组织破坏可能针对异常抗原的观点一致。
