Nature, nurture, and microbes: The development of multiple sclerosis

H Wekerle - Acta Neurologica Scandinavica, 2017 - Wiley Online Library
H Wekerle
Acta Neurologica Scandinavica, 2017Wiley Online Library
This paper argues that multiple sclerosis (MS) is the result of an autoimmune attack against
components of the central nervous system (CNS). The effector cells involved in the
pathogenic process are CNS‐autoreactive T cells present in the healthy immune system in a
resting state. Upon activation, these cells cross the blood‐brain barrier and attack the CNS
target tissue. Recent evidence indicates that autoimmune activation may happen in the
intestine, following an interaction of bacterial components of the gut flora with local CNS …
This paper argues that multiple sclerosis (MS) is the result of an autoimmune attack against components of the central nervous system (CNS). The effector cells involved in the pathogenic process are CNS‐autoreactive T cells present in the healthy immune system in a resting state. Upon activation, these cells cross the blood‐brain barrier and attack the CNS target tissue. Recent evidence indicates that autoimmune activation may happen in the intestine, following an interaction of bacterial components of the gut flora with local CNS autoreactive T cells. The consequences of this concept are discussed.
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