Hi 

I hope the following paper be useful.

Regards

Article Multiple Sclerosis: An Immune or Neurodegenerative Disorder?

Multiple sclerosis is traditionally considered as autoimmune disorder. However, what triggers this i.e., the etiology is still unknown. While demyelination was supposed to be the hallmark of the disease, axonal degeneration that accompanies this was primarily ignored in earlier studies/cases. There is always a neuroinflammatory component to this accompanied by demyelination and axonal degeneration. But what precedes what is still not conclusive. But it is true that axonal degeneration that happens in MS is gaining more light now and is thought to be one of the factors behind long term disability. However, it is still considered to be a neuroinflammatory demyelinating disease.

No at the early stages but can develop into NDD at more advanced stages secondary to the neuro-inflammation  and severe impairments of homeostatic regulations of neuronal functions..  

Thanks a lot Ali, Kaushiki and Saak for nice feedback 

Primary progressive MS is now a well-defined category. It represent 10-15% of the cohort of patients diagnosed with MS. So I think we can classify this entity as being neurodegenerative in nature. 

http://www.ncbi.nlm.nih.gov/pubmed/23418213

 First named 'Multiple Sclerose' in the 15th century. Multiple plaque formation  usually detected by MRI (white formations). Essentially a "burn out" of the capillaries resulting in astrocyte formation in the CNS brain & spinal cord. Individualized symptoms - ambulation dysfunction (usually unilateral), tetany, disorientation, memory loss, sight -blurring, speech. Over 60 pharmaceutical cures have not proven successful over the years - most are anti-inflammatory. Antibiotics, heat & humidity, aerobic exercise and particularly stress exacerbate symptoms. It is usually termed a neuro-inflmmatory autoimmune disease but there has been discussion that the blood brain barrier allows in substances - amino acids/proteins? that cause the inflammation. In my opinion MS should be termed a neurological disease as many of the symptoms closely resemble those of Parkinson Disease patients.

One has to keep in mind that MS is quite heterogenous. Thus, even the 85-90% RRMS dont necessarily have the same pathogenesis. There are arguments pro and contra the primary autoimmune or neurodegenerative origin (see the Review posted by Ali A R Adallal) but I doubt that one is able to draw a definitive conclusion at the moment for ALL MS cases. Strong arguments for the autoimmune hypothesis come from animal experiments (EAE) where MS-like symptoms can be clearly induced by autoimmune phenomena. But clearly, EAE does not reflect all aspects of MS, thus in principle a neurodegenerative pathogenesis can not be ruled out at least for a subgroup of MS patients.

Thanks everyone. Yes its true thats it is quite hard to say whats the etiology of MS?  Fred is right as it is heterogeneous and autoimmune hypothesis mainly has come from EAE model.. Thanks

Nematode filarial worm infestation may play a role in some cases of multiple sclerosis in the human host.  Ixodid ticks which vector Lyme disease carry nematode filarial worms in their gut along with multiple bacterial and viral Infectomes .

Regurgitation of Tick gut contents into the mammalian host transmits the entire gut content .

Posterlink;

https://www.dropbox.com/s/ht475ynewdr4qqt/Poster%20Worms%20in%20CSF.pptx?dl=0

Thanks Alan. 

Please go through the following RG links.

Chapter Multiple Sclerosis

Chapter Multiple Sclerosis and Neurodegenerative Diseases

Article Multiple sclerosis is primarily a neurodegenerative disease

The multiple sclerosis was considered as autoimmune disorder. Now some concepts are changed.

Certainly Yes

I think no one will doubt that the neurodegenerative component of the disease (axonal loss etc) is responsible for irreversible neurological disability. But the point is whether the pathogenetic cause of the disease is purely neurodegenerative or whether its autoimmune. I am not so sure that the concept completely changed in this respect. In my opinion there is still heterogenity with the majority of patients having a strong autoimmune component in the pathogenesis.

MS is absolutely an autoimmune disease. The pathogenesis is an aberrant mast cell that initiates an inflammatory cascade resulting in activation of Th-17 secreting IL-17 and GM-CSF which cause oxidative stress and recruit B-cell plasma and macrophages which attack oligodendrocytes, causing demyelination. Mast cells are the backbone of the innate immune system, and are found on all cutaneous tissue.

An autoimmune destruction of myelin nosology fails to explain why the myelin losses in a plaque of a MS patient are not mirrored by the Health of myelin in all brain sites within a 1cm radius from the

edge of the MS plaque.

This argues for plaque specific

Events for de- myelination

As opposed to total body myelin

Losses as would be predicted

In the auto -immune model

.

Alan MacDonald MD

MS should be regarded as both an autoimmune disease and a neurodegenerative disease. The autoimmune dysfunction starts with the capillary inflammatory flare and the astrocyte formation is the pathological end result. Thus the MS patient is left with a neurological disease which can flare from time to time depending on the particular type of MS and the particular manner that the patient reacts to the inflammatory process and usually under stress situations. It is true that the myelin degredation seen in the CNS does not always match what is seen on gadolinium contrast MRIs in terms of site and neurological pathways to the affected body regions. However, I do not have an answer for that. Perhaps this is the result of different neural pathways in the individual.