학술논문

Multiple Sclerosis as a Syndrome—Implications for Future Management
Document Type
article
Source
Frontiers in Neurology, Vol 11 (2020)
Subject
multiple sclerosis
syndrome
demyelination
innate immunity
pathophysiology
Neurology. Diseases of the nervous system
RC346-429
Language
English
ISSN
1664-2295
Abstract
We propose that multiple sclerosis (MS) is best characterized as a syndrome rather than a single disease because different pathogenetic mechanisms can result in the constellation of symptoms and signs by which MS is clinically characterized. We describe several cellular mechanisms that could generate inflammatory demyelination through disruption of homeostatic interactions between immune and neural cells. We illustrate that genomics is important in identifying phenocopies, in particular for primary progressive MS. We posit that molecular profiling, rather than traditional clinical phenotyping, will facilitate meaningful patient stratification, as illustrated by interactions between HLA and a regulator of homeostatic phagocytosis, MERTK. We envisage a personalized approach to MS management where genetic, molecular, and cellular information guides management.