Gulcher J R, Vartanian T, Stefansson K
Department of Neurology, Harvard Medical School, Boston, MA 02115, USA.
Clin Neurosci. 1994;2(3-4):246-52.
It is a commonly held view that multiple sclerosis (MS) may be an autoimmune disease. Most neurology texts list MS as an autoimmune disease and most texts on autoimmunity point to MS as a prime example of an autoimmune disease of the CNS. This view has influenced research into the pathogenesis of MS to the extent that most published work on MS is based on the assumption that it is correct, ignoring other possibilities, unless they can be put into an autoimmune context. Furthermore, most attempts at treating MS have been with agents that influence the immune system. Some of these agents, such as cytoxan and cyclosporin, are drugs with serious side-effects. Hence, it can be argued that over the years some MS patients have suffered because of the autoimmune hypothesis, although in the end and even today, other MS patients may benefit from it. This article examines some of the evidence in support of autoimmune hypotheses of the pathogenesis of MS. We believe that this examination shows that it has not been proven that MS is an autoimmune disease although it underscores the possibility that it may be so. Although it is still a reasonable hypothesis that MS is an autoimmune disease, it has yet to be proven and it would constitute a serious error of omission not to examine other possibilities.
人们普遍认为多发性硬化症（MS）可能是一种自身免疫性疾病。大多数神经病学教材将MS列为自身免疫性疾病，而大多数关于自身免疫性的教材则将MS作为中枢神经系统自身免疫性疾病的典型例子。这种观点对MS发病机制的研究产生了影响，以至于大多数已发表的关于MS的研究都是基于它是正确的这一假设，忽略了其他可能性，除非它们能被纳入自身免疫的背景中。此外，大多数治疗MS的尝试都使用了影响免疫系统的药物。其中一些药物，如环磷酰胺和环孢素，是有严重副作用的药物。因此，可以说多年来一些MS患者因自身免疫假说而受苦，尽管最终甚至在今天，其他MS患者可能从中受益。本文审视了一些支持MS发病机制自身免疫假说的证据。我们认为，这种审视表明，虽然强调了MS可能是自身免疫性疾病的可能性，但尚未证明MS是一种自身免疫性疾病。虽然MS是自身免疫性疾病仍然是一个合理的假说，但它尚未得到证实，如果不审视其他可能性，将构成严重的遗漏错误。
