ABSTRACT
Multiple sclerosis (MS) is the most important of the group of demyelinative diseases affecting the central and peripheral nervous systems (CNS, PNS). The distinction between diseases of the CNS and those of the PNS, in animals, depends exclusively on the antigen to which an immune response is induced, since lesions are elicited only in the area of distribution of the antigen used. Epidemiologic studies of MS leave little doubt that infection, viral infection in particular, plays a key role in initiating the MS disease process in susceptible individuals and in triggering renewed exacerbations of disease. T-cells in the perivascular infiltrates, the parenchymal lesions, and the normal-appearing tissue beyond the edges of the lesions show phenotypic markers of both helper/inducer and suppressor/cytotoxic classes. Many of the unusual findings in the cerebrospinal fluid discussed reflect B-cell- and plasma cell-mediated events in the CNS. Existing approaches to therapy in MS patients have been discussed in extenso elsewhere.
