The pathology of multiple sclerosis

The recognition of MS as a heterogeneous disorder with an inflammatory and a neurodegenerative phase requires the development of therapies that address not only the role of other targets in the disease (ie, myelin, oligodendrocyte, and axon) but also the role of different immune effector mechanisms (CD8 ⁺ T cells, antibody, complement, and so forth) and the potential need for different therapeutic strategies given at different stages of the disease. Recent genomic and proteomic technologic advances applied to MS neuropathology may help unravel the complexities of the MS lesion. Ultimately, the MS lesion is the target for therapy. A better understanding of the targets and mechanisms involved in lesion pathogenesis hopefully will lead to more effective therapeutic strategies.