Open AccessAxonal Damage in Multiple Sclerosis
Author(s) -
Haines Jeffery D.,
Inglese Matilde,
Casaccia Patrizia
Publication year - 2011
Publication title -
mount sinai journal of medicine: a journal of translational and personalized medicine
Language(s) - English
Resource type - Journals
eISSN - 1931-7581
pISSN - 0027-2507
DOI - 10.1002/msj.20246
Subject(s) - multiple sclerosis , medicine , myelin , central nervous system , pathogenesis , disease , neuroscience , degeneration (medical) , axonal degeneration , immune system , nervous system , immunology , pathology , biology , psychiatry
Multiple sclerosis is a debilitating disease of the central nervous system that has been characteristically classified as an immune‐mediated destruction of myelin, the protective coating on nerve fibers. Although the mechanisms responsible for the immune attack to central nervous system myelin have been the subject of intense investigation, more recent studies have focused on the neurodegenerative component, which is cause of clinical disability in young adults and appears to be only partially controlled by immunomodulatory therapies. Here, we review distinct, but not mutually exclusive, mechanisms of pathogenesis of axonal damage in multiple sclerosis patients that are either consequent to long‐term demyelination or independent from it. We propose that the complexity of axonal degeneration and the heterogeneity of the underlying pathogenetic mechanisms should be taken into consideration for the design of targeted therapeutic intervention. Mt Sinai J Med 78:231–243, 2011. © 2011 Mount Sinai School of Medicine