Monday, March 7, 2022

Multiple sclerosis

 Dr Chen, discussed the neurobiology of M.s and its mechanics. She discussed that MS is the auto immune inflammatory response to the myelin antigens. And that MS, represents activity in the central nervous system (CNS) . And she also talked a little bit about how MS affects the patient, not only physically but biologically as well. As we know many MS patients it isn't something that constantly affects the patient, but similar to many autoimmune diseases there are phases of remission, and disease known as flare ups. When MS flares up the central nervous system is directly affected,  the patient experiences increased fatigue of the arms and legs in some severe cases manifestations can include optic neuritis. And other manifestations can include inflammation in the colon IBD. And lupus. Unlike these other autoimmune diseases, MS causes demyelination and loss of oligodendrocytes as discussed by Dr Chen in her talk.  Relapses are fundamentally a manifestation of an inflammatory response occurring mostly in the white matter of the nervous system but also within myelin tracts in the gray matter. This results in focal demyelination with relative axonal sparing. This would account for the development of optic neuritis. Which affects the sight, this explains blurred vision and loss of vision for the patient. The best evidence for inflammation-induced relapses is confirmed through diagnostic imaging; the most reliable diagnostic we can use when dealing with MS would be MRI. which demonstrates the association of relapses with gadolinium enhancement, so a dye is injected intravenously which is disruption of the blood brain barrier. The main pathologic hallmark of MS is the demyelinated plaque, which has specific histological and immunohistological characteristics depending on the activity of the disease. This is the main indicator to diagnose MS. There have been cases of MS and inflammation causing lesions which are benign. This is most common, in the early phases of the diesease. To diagnose MS, the other diagnostic test used aside from imaging would be simple blood work. The stress induced blood marker that helps indicate MS induced stress kinases is elf2a. This is produced through a simple lab. 


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