MECHANISMS OF IMMUNE INJURY IN MULTIPLE-SCLEROSIS

In this review, we address current concepts regarding the mechanisms o f tissue damage that lead to demyelination and oligodendrocyte loss in multiple sclerosis. Particular emphasis has been placed on examining the MS lesion for evidence for pathogenetic processes that have been i mplicated from various in vivo and in vitro model systems. Central in this analysis has been the evaluation of the various effector cell typ es and their products. The results strongly support the conclusion tha t proinflammatory cytokines are major mediators of tissue damage, thro ugh the activation of inflammatory cells and resident glial cells. A r ole for antibody is also discussed, particularly as part of an antibod y-dependent cell-mediated demyelinating process. Minor populations of lymphocytes may also participate by defining the nature of the immunol ogical microenvironment.