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Multiple Sclerosis Is Not an Autoimmune Disease
Abhijit Chaudhuri, DM, MD, PhD, FACP, FRCP;
Peter O. Behan, DSc, MD, FRCP, FACP
Arch Neurol. 2004;61:1610-1612.
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Disease is very old and nothing about it has changed. It is we who change as we learn to recognize what was formerly imperceptible.—J. M. Charcot
The cause of multiple sclerosis (MS) and its pathogenesis are unknown, but 2 main theories have emerged: a viral cause and an autoimmune cause. In the past half century, however, research and therapy have been driven by the autoimmune hypothesis. We propose that MS is not an autoimmune disease but a genetically determined disorder characterized by metabolically dependent neurodegeneration.
AUTOIMMUNITY AND MS
The idea that MS may be a central nervous system, myelin-specific autoimmune disease is based on 2 sets of observations. The first is that fatal cases of acute disseminated encephalomyelitis (ADEM) have sleevelike, perivenous myelin damage up to 2 mm in diameter, in association with cellular infiltrates. The second observation is that . . . [Full Text of this Article]
MS THERAPY BASED ON AUTOIMMUNITY
MS IS A METABOLICALLY DEPENDENT, NEURODEGENERATIVE DISEASE
CONCLUSIONS
NOTE ADDED DURING FINAL SUBMISSION
AUTHOR INFORMATION
Author Affiliations: Division of Clinical Neurology, University of Glasgow, Scotland.
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