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Opportunities and Challenges

Corinna Trebst, MD; Richard M. Ransohoff, MD

Arch Neurol. 2001;58:1975-1980.

Multiple sclerosis is an autoimmune demyelinating disease of the human central nervous system with an unknown etiology. Crucial to its pathogenesis is the accumulation and activation of mononuclear cells in the central nervous system. Chemokines and their receptors are proposed to play a major role in the inflammatory recruitment of leukocytes. Besides analyses of relationships between chemokine or chemokine receptor gene polymorphisms and multiple sclerosis susceptibility and severity, analyses of chemokines and their receptors in patients with multiple sclerosis remain descriptive. In clinical material, chemokines and chemokine receptors can be examined in body fluids (blood and cerebrospinal fluid) and in brain tissues obtained via biopsy or autopsy. Research results will be summarized in this review, and a general model of leukocyte migration into the central nervous system under normal and inflammatory conditions will be proposed. Furthermore, opportunities and challenges for future investigations will be identified.

From the Department of Neurosciences (Drs Trebst and Ransohoff) and the Edward J. & Louise E. Mellen Center for Multiple Sclerosis Treatment and Research (Dr Ransohoff), The Cleveland Clinic Foundation, Cleveland, Ohio.

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