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Multiple Sclerosis (MS) And Immunology

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Title: Multiple Sclerosis (MS) And Immunology


1
Multiple Sclerosis (MS)And Immunology
  • 04???2? ???(???)
  • ??? ?? ???
  • ??? ??? ???

2
CASE
Multiple Sclerosis(MS)And Immunology
  • ??,?,28?,01?3?????????????,??????,????,??,??,????,
    ?????????????02?7????,???????,MRI?????????????????
    ?,???????????????,CSF????(),???????????
  • Mr. Shen,male,28 years old, he caught a cold in
    march, 2001.Then he got a descended physical
    strength, weak lower limbs, vision breakdown,
    diplopia , giddiness, urine retention
    ,dysequilibrium .He improved after symptomatic
    treatment.
  • On July,2002, the disease recurred. After
    examination, it shows multiple demyelinating
    disease in the white matter of the brain and the
    spinal cord on MRI. And the disorder in
    VEP,BAEP,SEP appeared. The OCB of CSF showed
    positive (), his final diagnosis was multiple
    sclerosis.

3
Multiple Sclerosis, MS?????
  • Definition MS is a mulifocality, demyelinating
    disease. It is charactered with recurrence and
    relieve.
  • Typical signs and symptoms affection of white
    matter transduction bundle of spinal cord, optic
    nerve, periventriclular white matter, brain stem
    and cerebella .
  • Mainstay of clinical diagnosis the affection of
    CNS white matter,the multiple refers to the
    multiple location and times.
  • ????????????????????????20???????????,??????????
    ????
  • ?????????????????????????????????????
  • ????????????????????????,?????????????

4
Etiological factor And Pathogenesis of MS
  • (?)  Etiological Factor
  • viral infection and autoimmune reaction
  • genetic factor
  • environmental factor
  • (?) Pathogenesis
  • some individual hereditary factor easily
    infected environment ( virus, cold) autoimmune
    reaction
  • ???MBP???????---- IL?Ab????????---- ???----??

5
?Pathogenesis of Immunology?
  • MBP(myelin basic protein)a kind of protein on the
    sheath cell in CNS.
  • In normal condition,as the existence of anatomy
    barrier, the autoreactive lymphocyte couldnt
    react on MBP. When the virus with the common
    antigen of MBP invade the human body, barrier
    will break down.
  • When the virus infect the body, the T/B cells are
    activated ,then the cellular and humoral immunity
    are initiated. The immunological products
    (effective T cell and Ab ) react with MBP, the
    sheath cells are killed and cause the demyelin,
    then it is multiple sclerosis.

6
MS is mainly a T cell disease
??????(myelin basic protein,MBP),MBP?????????????
????????????(experiment allergic
encephalo.myelitis,EAE)
7
Detailed Immunological Mechanism
IgG IgA IgE IgM
Plasma
B2 cell
Ab
??
TD-Ag
Th2
CD4 T
Th1
Innate immunity
??
Target cell
APC
T cell
CD8 T
CTL
TI-Ag
B1 cell
Plasma
AbIgM
8
Sensitization StageAPC presentation
  • Endogenous
  • -MHC I
  • Exogenous
  • -MHC II

9
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10
Reaction stagesheath cells and virus infected
cells
11
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12
Activation of B2 cells
13
ADCC
14
CLASSICAL PATHWAY OF COMPLEMENT ACTIVATION
15
  • ??????????????????
  • (1)???????????
  • (2)???Fc????????????
  • (3)???????????????????????????????

16
MS
  • cellular immunityMBP has the common antigen with
    virus, the immune tolerance can be broken by the
    invasion of virus. The CTL attack both the sheath
    cells and the virus infected cells.
  • Humoral immunity play a part in the formation
    and the perpetual existence of impairment.
  • The study of the detailed mechanism is undergoing

17
Treatment Prognosis
  • Treatment
  • Principleimprove the quality
  • Drug treatment
  • 1. hormonal therapy????? ??????????ACTH
  • 2. plasmapheresis
  • 3. immune depressant?????????
  • CsA,
    FK506
  • 4.IFN-ß
  • 5. prevention and cure antibiotics
  • 6. rehabilitation care
  • Prognosis
  • good ,however ,it has death rate

18
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