Levin Michael C, Douglas Joshua N, Meyers Lindsay, Lee Sangmin, Shin Yoojin, Gardner Lidia A
Veterans Administration Medical Center.
Department of Neuroscience, University of Tennessee Health Science Center, Memphis, TN, USA.
Degener Neurol Neuromuscul Dis. 2014 Mar 12;4:49-63. doi: 10.2147/DNND.S54391. eCollection 2014.
Multiple sclerosis (MS) is a complex autoimmune disease that impairs the central nervous system (CNS). The neurological disability and clinical course of the disease is highly variable and unpredictable from one patient to another. The cause of MS is still unknown, but it is thought to occur in genetically susceptible individuals who develop disease due to a nongenetic trigger, such as altered metabolism, a virus, or other environmental factors. MS patients develop progressive, irreversible, neurological disability associated with neuronal and axonal damage, collectively known as neurodegeneration. Neurodegeneration was traditionally considered as a secondary phenomenon to inflammation and demyelination. However, recent data indicate that neurodegeneration develops along with inflammation and demyelination. Thus, MS is increasingly recognized as a neurodegenerative disease triggered by an inflammatory attack of the CNS. While both inflammation and demyelination are well described and understood cellular processes, neurodegeneration might be defined by a diverse pool of any of the following: neuronal cell death, apoptosis, necrosis, and virtual hypoxia. In this review, we present multiple theories and supporting evidence that identify common biological processes that contribute to neurodegeneration in MS.
多发性硬化症（MS）是一种损害中枢神经系统（CNS）的复杂自身免疫性疾病。该疾病的神经功能障碍和临床病程在不同患者之间差异很大且难以预测。MS的病因仍不明确，但一般认为它发生在具有遗传易感性的个体中，这些个体由于非遗传触发因素，如代谢改变、病毒或其他环境因素而发病。MS患者会出现与神经元和轴突损伤相关的进行性、不可逆的神经功能障碍，统称为神经退行性变。传统上，神经退行性变被认为是炎症和脱髓鞘的继发现象。然而，最近的数据表明，神经退行性变与炎症和脱髓鞘同时发生。因此，MS越来越被认为是一种由中枢神经系统炎症攻击引发的神经退行性疾病。虽然炎症和脱髓鞘是已被充分描述和理解的细胞过程，但神经退行性变可能由以下多种情况定义：神经元细胞死亡、凋亡、坏死和虚拟缺氧。在本综述中，我们提出了多种理论及支持证据，以确定导致MS神经退行性变的常见生物学过程。
