ARE CURRENT IMMUNOLOGICAL CONCEPTS OF MULTIPLE-SCLEROSIS REFLECTED BYTHE IMMUNOPATHOLOGY OF ITS LESIONS

Immunopathological studies on multiple sclerosis (MS) brain clearly in dicate that a T cell-mediated immune response is the driving force in the induction of the lesions. This T cell-mediated response alone, how ever, is not sufficient to explain the widespread and selective destru ction of myelin sheaths. According to present evidence, it is likely t hat antibodies directed against surface components of myelin sheaths a re at least one factor involved in the demyelinating a process. The pa tterns of inflammation, demyelination and oligodendrocyte destruction, however, suggest that the pathogenesis of the lesions may be fundamen tally different in individual MS patients and that autoimmunity may no t be the sole cause. In the case of autoimmune reactions various diffe rent proteins of the nervous system may become targets and it appears unlikely, that myelin basic protein is a major candidate for a pathoge netic role in MS.