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P.A. MURARO, A. LUGARESI, D. GAMBI Many of the pathological aspects of multiple sclerosis (MS) lesions have been known for over a century. It is only recently, however, that different patterns of demyelination have been linked to distinct pathways of immune-mediated tissue destruction. In particular, the inter-individual heterogeneity of MS lesions has suggested that different mechanisms may act in different patients, accounting for the variability observed in clinical course, immunological findings in peripheral blood and cere brospinal fluid (CSF), and response to immunomodulatory treatments. To provide an overview of the basic mechanisms possibly involved in MS lesion initiation and development, an international meeting was organized in the context of the annual Congress of the Italian Neuroimmunology Association (AINI), held at the University of Chieti, in Chieti Italy on 29 October 1998. The high standard of presentations prompted us to report them in extended form, to highlight recent pro gress in the understanding of basic mechanisms sustaining MS immuno pathogenesis. A central role in the possible mechanisms leading to myelin destruc tion has been attributed to T lymphocytes reactive to myelin antigens. Studies on the myelin antigen-specific T cell repertoire have contributed significant advances to our knowledge of autoimmunity (Chapters 1,2).
Designing immunotherapeutics, drugs, and anti-inflammatory reagents has been at the forefront of autoimmune research, in particular multiple sclerosis, for over 20 years. Delivery methods that are used to modulate effective and long-lasting immune responses have been the major focus. This Special Issue focused on delivery methods to be used for vaccines, immunotherapeutic approaches, drug design, and anti-inflammatories and their outcomes in preclinical studies and clinical trials.
Over the past decade, we have made great advances in the field of multiple sclerosis (MS) research, and this book focuses on those advances in MS pathogenesis and treatment. While some of these advances have been through new approaches and ideas that have emerged in the last decade such as the newly identified protective role that amyloid proteins may play in MS or the use of helminths to treat autoimmune diseases, others have evolved from previous theories and ideas that have only now gained momentum and a deeper understanding such as the role of HLA or gender in MS susceptibility. This book covers these emerging and evolving topics and highlights the substantial advancements made in elucidation of the factors regulating susceptibility or disease progression, identification of new ways to monitor or predict MS pathology, and development of new strategies for treating MS.
Looking at the lastest advances in research into multiple sclerosis, from genetics to the use of magnetic resonance imaging and the organization of MS care.
This volume highlights recent advances in the basic mechanisms of the immunopathogenesis of multiple sclerosis. Written by scientists actively involved in leading research, it mainly focuses on aspects of autoreactive T cell activation. Progress in the field of blood-brain barrier damage pathophysiology, antigen presentation in the central nervous system and magnetic resonance imaging are also reported. Providing a rapid access to up-to-date, leading research on basic pathogenetic mechanisms of multiple sclerosis, this book is directed not only to neuroimmunologists, but also to a general neurological readership.
The availability of powerful genome-wide association study technology, during the last five years, has shown that most of the “new” MS susceptibility loci are immune-response genes. It is clear that there is much novelty in the field of MS immunology, which has served as an impetus to invest in new therapies. Notably, most if not all of these are immunotherapies. Even the equally exciting field of cell-based therapies and neuro-regeneration may well rely on cells or growth factors that are no less immunomodulators than restorative of myelin and neural cell function. Multiple Sclerosis Immunology looks at MS immunology as the basis for the present and—even more—the future of treatments for this complex autoimmune condition. Both editors are immunologists, as well as clinical neurologists, and appreciate the importance of a sustained dialogue between basic and clinical scientists to ensure that “translation” is real and not just virtual.
Knowledge has been described as being like an expanding sphere with the volume of knowledge contacting a surface on the unknown. This new comprehensive review of the many fields of basic and clinical research that impact our understanding of multiple sclerosis has its basis in this premise. In doing research on MS, it is not enough to know clinical neurology or neurochemistry or neuroanatomy or pathology; it is important to understand the many other areas that relate to them. This volume provides an overview of MS-related research and will benefit many investigators in the field and help to advance our efforts to cure this, thus far intractable, disease. It is now more than 160 years since the first clinical-pathological descriptions of cases of multiple sclerosis and more than 130 years since the classic clinical description and development of diagnostic criteria by Charcot, yet MS remains an enigma. After decades of intense effort to find the cause, no cause has been clearly identified and the disease remains poorly understood. Despite the introduction of immunomodulatory therapies and immunosuppressive regimens, MS remains a devastating disease. While a great deal of progress has been made, much remains to be done. Our understanding of the disease remains limited, treatments remain inadequate, and comprehensive management all too rare. This volume is an overview of the basic sciences as they relate to MS and will provide clinicians and investigators a better understanding of the basic aspects of the disease. While it is possible to find excellent reviews of almost any aspect of MS, few attempts have been made to bring these very different aspects together in a single source. This volume is a companion to Multiple Sclerosis: Diagnosis, Medical Management, and Rehabilitation, edited by Drs. Jack S. Burks and Kenneth P. Johnson. Together, they represent an attempt to comprehensively cover the field of MS from basic research to comprehensive management and to provide a broad overview for those interested in understanding the disease better or in pursuing MS research.