Topic 6 - Multiple Sclerosis

Define Multiple Sclerosis

chronic autoimmune disease characterized by damage to myelin and oligodendrocytes

Identify the major causes of MS

Genetics, bacterial viral infection, pesticides

Do genetics or environmental factors play a larger role in MS

Environmental Dominates (70-80%)

Describe the Vitamin D hypothesis in reference to MS development

Vitamin D lessens the inflammatory impact of neurodegenerative and neuroimmune disease

Define molecular mimicry

EBV-specific t cells or antibodies could falsely recognize and attack CNS auto antigens

Describe MS Genetic Factors

Polygenetic

HLA genes are the strongest genetic risk

Describe HLA genes

controls how antigens are presented to T-cells

Identify the areas of the body affected by MS

Brain, Spinal Cord, Optic Nerves

Identify symptoms of MS

Abnormal sensations, difficulty walking, bladder problems

Identify how MS affects the spinal cord

Weakness and sensory loss

Identify how MS affects the Cerebellum

Ataxia, tremor

Describe how MS affects the optic nerve

vision loss

Describe the Autoimmune hypothesis of MS

Peripheral immune cells form blood vessels enter the CNS or optic nerves and cause inflammation, demyelination and neuronal damage

Identify the two components of the initiation of MS

Peripheral immune activation and Blood Brain Barrier Breakdown

Describe Blood Brain Barrier Breakdown in the progression of MS

Earliest pathological event,

Describe the vulnerabilities of oligodendrocytes and myelin

Myelin is easily targeted by immune cells once exposed

oligodendrocytes are often not a primary target but suffer bystander injury

Describe Relapsing Remitting MS

Short duration, most common type of MS (85%)

Describe Secondary Progressive MS

Most of the people who get diagnosed with RRMS will eventually transition to SPMS

Slow and steady progression

Describe Primary Progressive MS

Steady worsening from the start

Do not have periodic relapses and remissions

Describe Progressive Relapsing MS

Steadily worsens from onset

Flare ups with or without remission are also present

Describe MRI Scans in relation to MS

MRIs obtained over the course of 3 years show enlarging of focal lesions over time

What is the main thing doctors look for in an MRI when diagnosing MS

Evidence of lesions in the CNS

What do all testing forms for MS have in common

All testing forms are attempting to identify lesions or damage to BBB

Describe what a Gadolinium enhancement is used for

Used to detect a compromised BBB or lesions with active inflammation

Describe the usage of Spinal Tap in relation to MS

Used to rule out other diseases and confirm MS diagnosis

Define oligoclonal bands

The presence of two or more protein bands of a specific immunoglobin