McFarland H F, Dhib-Jalbut S
Neuroimmunology Branch, NINCDS, Bethesda, Maryland 20892.
Clin Immunol Immunopathol. 1989 Jan;50(1 Pt 2):S96-105. doi: 10.1016/0090-1229(89)90116-5.
Multiple sclerosis is the principal demyelinating disease of the central nervous system. Although the prevalence of the disease is moderately low, averaging about 40 cases per 100,000 people in high risk areas, it is a particularly devastating disease. It primarily affects young adults, is chronic, and has an unpredictable course. Most discouraging, the cause of the disease is not known and an effective treatment has not been identified. Recently, however, research has yielded some important findings concerning the etiology of MS. Much evidence now points to an immunological process as one of the major elements in the disease. It is also likely that an environmental influence, possibly an infectious process, may contribute to the disease. Finally, it is now certain that genetic makeup influences susceptibility to the disease. At present, the strongest evidence is for a polygenic effect, not the effect of a single gene or gene locus. This review will examine some of the possible immunologically mediated disease processes that could be involved in MS, especially those that could account for a role for infectious and genetic factors in the disease.
多发性硬化症是中枢神经系统主要的脱髓鞘疾病。尽管该病的患病率适中偏低，在高危地区平均每10万人中约有40例，但它是一种特别具有破坏性的疾病。它主要影响年轻人，病程慢性且不可预测。最令人沮丧的是，该病的病因不明，也尚未确定有效的治疗方法。然而，最近的研究在多发性硬化症的病因方面取得了一些重要发现。现在有很多证据表明免疫过程是该疾病的主要因素之一。环境影响，可能是感染过程，也可能导致该病。最后，现在可以确定的是，基因构成会影响对该病的易感性。目前，最有力的证据支持多基因效应，而非单一基因或基因位点的效应。本综述将探讨一些可能参与多发性硬化症的免疫介导疾病过程，尤其是那些可以解释感染和遗传因素在该疾病中作用的过程。
