Positive and negative implications of tumor necrosis factor neutralization for the pathogenesis of multiple sclerosis.

Multiple sclerosis (MS) is a progressive, presumably autoimmune, degenerative disease of the central nervous system (CNS). The mechanisms which trigger the disease are unknown, but the pathology of MS is caused by the host's own immune system, which invades the CNS and attacks the myelin sheath that protects and insulates the axons of the nerve cells. Although this inflammatory assault selectively destroys myelin, it is believed that the neurological deficits of MS are rather the consequence of damage to axons, which occurs secondary to inflammation. The inflammatory mediators are generally secreted by myelin-specific, CD4+ T cells, CD8+ T cells, macrophages and activated glial cells and include a large number of cytokines, chemokines and other proinflammatory proteins. Copyright (c) 2008 S. Karger AG, Basel.