Department of Physics, European School of Molecular Medicine (SEMM), IFOM-IEO Campus, Centro Interdisciplinare Materiali e Interfacce Nanostrutturati, University of Milan, Milan, Italy.
J Cereb Blood Flow Metab. 2009 Dec;29(12):1867-78. doi: 10.1038/jcbfm.2009.180. Epub 2009 Sep 2.
Multiple sclerosis (MS) is primarily an autoimmune disorder of unknown origin. This review focuses iron overload and oxidative stress as surrounding cause that leads to immunomodulation in chronic MS. Iron overload has been demonstrated in MS lesions, as a feature common with other neurodegenerative disorders. However, the recent description of chronic cerebrospinal venous insufficiency (CCSVI) associated to MS, with significant anomalies in cerebral venous outflow hemodynamics, permit to propose a parallel with chronic venous disorders (CVDs) in the mechanism of iron deposition. Abnormal cerebral venous reflux is peculiar to MS, and was not found in a miscellaneous of patients affected by other neurodegenerative disorders characterized by iron stores, such as Parkinson's, Alzheimer's, amyotrophic lateral sclerosis. Several recently published studies support the hypothesis that MS progresses along the venous vasculature. The peculiarity of CCSVI-related cerebral venous blood flow disturbances, together with the histology of the perivenous spaces and recent findings from advanced magnetic resonance imaging techniques, support the hypothesis that iron deposits in MS are a consequence of altered cerebral venous return and chronic insufficient venous drainage.
多发性硬化症（MS）主要是一种病因不明的自身免疫性疾病。本综述重点关注铁过载和氧化应激作为导致慢性 MS 免疫调节的周围原因。铁过载已在 MS 病变中得到证实，这是与其他神经退行性疾病共同的特征。然而，最近描述的与 MS 相关的慢性脑脊髓静脉功能不全（CCSVI），伴有显著的脑静脉流出血流动力学异常，允许在铁沉积的机制中提出与慢性静脉疾病（CVDs）的平行关系。异常的脑静脉反流是 MS 的特征，在一组患有其他以铁储存为特征的神经退行性疾病的患者中未发现，如帕金森病、阿尔茨海默病、肌萎缩侧索硬化症。最近发表的几项研究支持 MS 沿着静脉血管进展的假说。CCSVI 相关的脑静脉血流紊乱的特点，以及围绕静脉的空间的组织学和最近的先进磁共振成像技术的发现，支持铁沉积在 MS 中是改变脑静脉回流和慢性静脉引流不足的结果的假说。
