Multiple Sclerosis (MS)
By Drs.Li-Ke Wu, Xiaojuan Wang, Bo Cheng, Susan Chu and Xinrui Xi
Wu Medical Center, Bejing, China
Through long-term practice, doctors have been able to identify the disease whose characteristics are myelinolysis in the brain and spinal cord to demyelinating disease of the central nervous system. The most common type of demyelinating disease is MS.
Nosogenesis: MS is related to a virus infection and post-infectious autoimmune mechanism.
Classification: 1. Multiple Sclerosis
A. Chronic recurrent cerebral spinal cord sclerosis
B. Acute multiple sclerosis
C. Schilder's diffuse cerebral sclerosis and Balo concentric diffuse cerebral sclerosis
2. Optic nerve myelin inflammation (Devic's disease)
3. Acute disseminated encephalomyelitis: after hives, crystalli infection or after some vaccine inoculation
4. Acute and sub-acute necrotizing hemorrhagic encephalitis
Pathology:
1. Medullated nerve fiber damage.
2. Other neural tissue components somewhat remain.
3. Blood vessels in the corresponding area effuse into acute inflammation.
4. Presence of characteristic lesion distribution.
5. Few Wallerian degeneration or secondary fiber bundle degeneration.
MS can represent this kind of disease, because it has a high incidence rate, chronic course, susceptibility to affect adolescents, therefore MS is one of the major nervous system diseases.
Disease characteristics: tends to invade certain parts of the central nervous system, causes severe fatigue and some complex symptoms and physical signs, and the change of radiological images makes it easily recognizable.
Clinical manifestation:
Include: Motor weakness, limb paresis or paralysis, abnormal sensation, visual impairment, diplopia, nystagmus, ataxia and bladder dysfunction (urinary incontinence) and so on.
Laboratory examination abnormal item: cytology of cerebrospinal fluid, protein. Radiographic: abnormal T2 magnetic resonance signal around encephalocoele, located in multiple, scattered lesions. About half of the patients show intermittent progress, some patients have continuing progress (durative aggravation).
The clinical course and prognosis: the important clinical characteristics of MS include recurrent attacks, exacerbations and each occurrence is within a series of attacks, which shortens the remission period.
Some patients show a series of relapses and aggravation, which may cause paralysis of limbs and bulbar paralysis, which can lead to difficulty breathing and swallowing; the related pathologic processes remain and the potential motility during a very long period. Immunosuppression is the main treatment during the period afterwards, such as corticosteroid, interferon, and cell type inhibitors, which achieve effective medical outcomes to a certain extent. However, it is unknown how to stop the course of the disease.
WSCMC's current research found: the neural stem cells are able to repair damages of the neural myelin and axons while the mesenchymal stem cells are able to adjust the autoimmune status, which can slow down or even halt the progression of the disease while repairing the neural lesions that already exist. It is important to emphasize: the biological treatment cannot be the only method used (the cells treatment), otherwise the implantation of cells cannot survive or have normal functions. In order to achieve the best outcome, one should combine taking certain amounts of medication and doing physical therapy.
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