Multiple sclerosis is primarily a neurodegenerative disease
Multiple sclerosis is primarily a neurodegenerative disease
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DOI：
10.1007/s00702-013-1080-3
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发表时间：
2013-10-01
影响因子：
3.3
通讯作者：
Chaudhuri, Abhijit
中科院分区：
文献类型：
--
作者：
Chaudhuri, Abhijit
多发性硬化症的确切发病机制尚不清楚。该疾病的主要免疫发病机制的假设存在严重缺陷，并且未能为大多数患者提供有效的治疗。灰质和白色物质的进行性变性是疾病自然史的组成部分，并反映在脑和脊髓的萎缩中。脱髓鞘是这种主要神经退行性过程的重要组成部分，而不是全身免疫反应的目标。多发性硬化的主要病理是基于血脑屏障完整性的神经变性过程。原发性进行性多发性硬化症是神经退行性疾病的原型，年轻人群中的复发缓解型代表了类固醇（维生素D、性激素和应激激素）对中枢神经系统代谢功能的调节作用。
The precise pathogenesis of multiple sclerosis is unknown. The assumption of a primary immunopathogenesis of the disease is seriously flawed and has failed to deliver an effective therapy for most patients. The progressive degeneration of grey and white matter is integral to the natural history of the disease and is reflected in the atrophy of brain and spinal cord. Demyelination is an essential component of this primary neurodegenerative process rather than the target of a systemic immune response. The primary pathology of multiple sclerosis is a process of neurodegeneration based on the integrity of the blood-brain barrier. Primary progressive multiple sclerosis is the prototype neurodegenerative disease, and the relapsing-remitting form in younger population represents the modifying effect of steroids (vitamin D, sex and stress hormones) on metabolic functions of the central nervous system.