Multiple Sclerosis: Basic Concepts and Hypothesis


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49 Scopus citations


Multiple sclerosis, an inflammatory disease of the central nervous system, is characterized by primary destruction of myelin. This review covers recent advances in neuropathology, immunogenetics, neuroimmunology, and neurovirology that have provided insights regarding its pathogenesis. Three hypotheses are discussed: (1) autoimmunity, (2) “bystander” demyelination, and (3) immune destruction of persistently infected oligodendrocytes. A paradigm for induction of primary demyelination is proposed in which immune cells recognize “foreign” antigens on the surface of oligodendrocytes in the context of major histocompatibility complex gene products. The final result of this scheme may be “dying-back gliopathy,” the alteration being noted first in the most distal extension of the oligodendrocyte—that is, the myelin sheaths.

Original languageEnglish (US)
Pages (from-to)570-576
Number of pages7
JournalMayo Clinic proceedings
Issue number5
StatePublished - 1989

ASJC Scopus subject areas

  • Medicine(all)


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