Title: Multiple Sclerosis (MS) And Immunology
1Multiple Sclerosis (MS)And Immunology
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2CASE
Multiple Sclerosis(MS)And Immunology
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?,???????????????,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.
3Multiple 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.
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4Etiological 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.
6MS is mainly a T cell disease
??????(myelin basic protein,MBP),MBP?????????????
????????????(experiment allergic
encephalo.myelitis,EAE)
7Detailed 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
8Sensitization StageAPC presentation
- Endogenous
- -MHC I
- Exogenous
- -MHC II
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10Reaction stagesheath cells and virus infected
cells
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12Activation of B2 cells
13ADCC
14CLASSICAL PATHWAY OF COMPLEMENT ACTIVATION
15- ??????????????????
- (1)???????????
- (2)???Fc????????????
- (3)???????????????????????????????
16MS
- 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
17Treatment 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
18Thank You