Disease modification in multiple sclerosis.

Simplified Pathology of NIS In MS, T cells are inappropriately activated to recognize myelin and myelin-forming cells (oligodendrocytes) as foreign which results in starting of an autoimmune process. This inappropriate immune response can cause the production of cytokines that continue to activate T cells and cause additional damage to the myelin. The first stage in the cascade leading to MS is the inflammatory reaction. White cells penetrate the protective blood-brain barrier (BBB) by traveling from the blood stream into the CNS and settling around the tiny blood vessels. As these white cells (predominantly T cells) enter the CNS, they produce inflammatory proteins called cytokines. The presence of these inflammatory cells and inflammatory proteins lead to edema. This "focal" or localized inflammation around small blood vessels is one of the hallmarks of MS. This causes swelling and damage to the surrounding tissue. 3 "`+