This paper reflects the research and thoughts of a student at the time the paper was written for a course at Bryn Mawr College. Like other materials on Serendip, it is not intended to be "authoritative" but rather to help others further develop their own explorations. Web links were active as of the time the paper was posted but are not updated.
Contribute Thoughts | Search Serendip for Other Papers | Serendip Home Page
2003 First Web Paper
The primary objective of this paper is to raise fundamental questions in regards to multiple sclerosis, and to explore possibilities that attempt to answer these inquiries. Second, the prospective outcome is to provide a solid knowledge base for which my peers may begin to understand the relationship between multiple sclerosis and neurobiology and behavior. The first question to address in the general schema of this essay is: What is Multiple Sclerosis?
Multiple Sclerosis also commonly referred to as MS is considered an autoimmune disease that affects the central nervous system (CNS). The key to understanding MS is to recognize its relationship to the human immune system. The immune system is an intricate network of specialized cells and organs that defends the body against attacks by foreign agents also known as antigens such as bacteria, viruses, fungi, and parasites. To the contrary, in the case of multiple sclerosis, the connection between the immune system and the body is interrupted when the immune system identifies itself, particularly the white matter of the central nervous system as a foreign body, and consequently destroys the myelin. The myelin is a fatty tissue composed of rich protein and lipids that protect and insulate the nerve fibers, which serve to carry out electrical impulses. The central nervous system is made up of the brain, spinal cord, and optic nerves; thusly MS affects several areas of the human anatomy.
Multiple Sclerosis could be described as the loss of myelin in multiple locations throughout the body, which then exposes the nerve fibers and leaves scaring called sclerosis. The next question that should be addressed is: What are the principal functions of myelin? In addition to protecting nerve fibers myelin is fundamental in the process of conduction of electrical impulses to and from the brain to other parts of the body. The transmission of electrical impulses will be hindered as a direct consequence of damaged or destroyed myelin. One may ask why does the body begin to attack and destroy the myelin? This question ultimately leads to the inquiry: What causes multiple sclerosis? The response is that the exact origin of MS is unknown, and that scientists and researchers suspect that the damage to the myelin results from an abnormal response by the body's immune system. In other wards science cannot explain this phenomena. However, research is making advances in the area of MS, and the future for those who are affected by multiple sclerosis appears to be more optimistic.
In most recent years, scientists have created a group of tools that provide them with the capacity to target the genetic influences that make an individual prone to multiple sclerosis. Molecular genetics has provided a model for which these instruments are utilized to separate and determine the chemical structure of genes. Since the 1980's, scientists have begun to apply the tools of molecular genetics to human diseases that are attributed to genetic defects in individual genes. Now, some scientists are convinced that one may be "susceptible to MS only if she or he inherits an unlucky combination of alterations in several genes." An example that demonstrates progress in the area of MS research; by 1996 it was reported that up to twenty locations that may contain genes contributing to MS were recognized, but a specific gene was not documented to have a significant impact on the susceptibility of Multiple Sclerosis. Once the gene that accounts for a predisposition to MS is identified, subsequently researchers will address the influence that this gene has in the immune system and on the neurological aspect. This leads me to the following query: Who gets MS? The response to this question is that anyone may develop multiple sclerosis, but that there are some known patterns. The most widely accepted and documented epidemiological observations of MS are: that there is a significantly greater frequency in a latitude of 40� or more away from the equator, than in a lower latitude closer to the equator, in the U.S. MS occurs more often in states that are above the 37th parallel than in states below it, an individual who is born in an area with a higher risk of developing MS and moves to an area of lower risk, acquires the risk of the new residency if relocation occurs prior to adolescence, MS is more prevalent among Caucasians, (particularly those of northern European ancestry) than other races, Multiple Sclerosis is 2-3 times as common in women than in men, and in specific populations, a genetic marker has been linked to MS. These factors are diverse in nature and could be considered environmental, immunologic, viral, and or genetic factors. However, approximately 400,000 Americans have been diagnosed with having multiple sclerosis, and in addition every week 200 people are diagnosed. On a much larger scale, worldwide MS may affect 2.5 million individuals.
As people are affected either directly or indirectly: What can be done to promote awareness? The response is to become empowered by seeking education about multiple sclerosis, and share your knowledge with others. An aspect of becoming more informed about this autoimmune disease is to be aware of the symptoms. The symptoms of MS are unpredictable and vary from individual to individual, but some of the most common symptoms are bladder, bowel, sexual dysfunction, abnormal fatigue, lack of balance and muscle coordination, cognitive, emotional, and vision problems, and several more symptoms. Often, MS is misdiagnosed because of the array of symptoms. The two fundamental signs for confirming multiple sclerosis are; signs of disease in different parts of the nervous system and signs of at least two separate exacerbations of the disease. Once an individual experiences symptoms and is diagnosed with MS: What are the options available as far as treatment is concerned?
Unfortunately, there is not a cure, but rather treatments that have been proven effective in slowing down the progression of the disease. The medications most commonly used to treat MS are Glatiramer Acetate, Interferon beta-1a, Interferon beta-1b, and Mitoxantrone. Except for Mitoxantrone the medications listed above are types of proteins manufactured by a biotechnological process from one of the naturally occurring interferons. To the contrary Mitoxantrone belongs to the general group of medicines called antineoplastics. It acts in MS by suppressing the activity of T cells, B cells, and macrophages that are thought to lead the attack on the myelin sheath. People diagnosed and properly treated for multiple sclerosis may live a normal life expectancy, and maintain an active lifestyle. It all depends upon the state of mind of the individual. My mother is a primary example, that MS does not have to control one's life, but to the contrary an individual has the power to control it.
There are several important aspects of living with this disease, instead of at its mercy. First, one needs to acknowledge the existence of the disease. Second, an individual should allow time to process the idea of living with the disease. Third, one should become an active agent in fighting the disease by becoming informed. Fourth, a person should be willing to make adjustments, which may alter one's lifestyle. In conclusion an individual should not be afraid of multiple sclerosis, but dare to live a fulfilling life.
For further information check out
Send us your comments at Serendip
| Course Home Page | Course Forum | Brain and Behavior | Serendip Home |
© by Serendip 1994- - Last Modified: Saturday, 18-Nov-2017 15:50:03 EST
described below summarize the committee's conclusions about which directions appear most likely to provide the fundamental knowledge that can lead to the development of effective therapies (see Box 1 for summary).
RECOMMENDATION 1: Research on the pathological changes underlying the natural course of MS should be emphasized, because it provides the key to predicting disease course in individual patients, understanding the physiological basis of MS, and a basis for developing improved therapeutic approaches.
Unpredictability imposes a particularly acute burden on people with MS. They have no way of knowing when a relapse will occur, how impaired they will be, or whether they will recover from the relapse. Yet it is now clear that disease activity precedes relapses. Understanding these pathological changes is the first step toward predicting—at least in the short term—disease progression in individual patients.
Research on the natural course of MS would include defining the relationship between cellular and molecular changes and the progression of disability, as well as determining the physiological basis for different clinical manifestations of MS. Changes in gene expression should be analyzed in individual cell types, particularly those in and at the borders of lesions. Such information will also improve the ability to develop more refined diagnostic tools, provide benchmarks against which to measure the effect of therapeutic interventions, and provide the scientific basis to identify new therapeutic approaches.
Research on pathological changes occurring early in the disease should be particularly emphasized. This should also include the development of improved diagnostic criteria (most likely, criteria based on neuroimaging) that allow early and more accurate diagnoses of MS. If aggressive treatment is to be instituted at the onset of disease, early and accurate diagnosis is especially important.
RECOMMENDATION 2: Research should be pursued to identify how neurons are damaged in MS, how this damage can be prevented, and how oligodendrocytes and astrocytes are involved in damage and repair processes.
Oligodendrocytes, astrocytes, and neurons can, in a sense, all be regarded as the cellular “victims” in multiple sclerosis. It is clear that oligodendrocytes and the myelin sheaths they form are damaged, astrocytes respond by forming a glial scar, and in some cases, axons (outgrowths of neurons) degenerate in MS. However, a better understanding of the neuronal response to injury and capacity for repair, the capacity of myelin-forming cells to remyelinate neurons and restore function, and the contribution of astrocytes is essential to deciphering the neuropathology of MS. Although much is known, many questions remain, and their answers have important implications for therapy.