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Multiple Sclerosis (MS)
Presented By: Alyssa Sturm &
Brittany Gray
December 4, 2012
What Are the Symptomsof MS?
• Primary symptoms
Loss of motor skills
Loss of senses
Physiological fatigue
Speech problems
Memory impairment
• Other symptoms depend on patient
Figure 1. Th Cell Invasion of Blood-Brain Barrier
Figure 2. Unmyelinated vs. Myelinated Axons
What is the History of MS?
• Robert Carswell-1838
▫ Described features of MS
• Jean-Martin Charcot-19th century
• Noted specific symptoms:
▫ Memory issues
▫ Slowed thinking
▫ Intellectual dysfunction
Figure 3. Criteria for Diagnosing MS
What is the Epidemiology of MS?
• 400,000 Americans
• 2.5 million world wide
• Incidence
▫ 7 new cases per 100,000 people per year
▫ Lifetime risk of 1/400
• Onset
▫ Twice as likely in females
What Are the Risk Factors of MS?
• Environmental Factors
▫ Diet, air pollutants, cigarettes, vitamin-D deficiency, ect.
▫ Epstein-Barr Virus, Measels, Mumps
• Genetic Factors
▫ HLA DR15 and DQ6
 Different MHC involved
 Myelin Proteins
What is the Immunopathology of MS?
• Regulatory lymphocyte defect
• β-arrestin 1
What is the Immunopathology of MS?
•Myelin basic protein
• Molecular mimicry
What Are Triggers and Risk Factors of
• Infections
• High pollution
• Disease
• First degree relative with MS
What Treatments Are Available?
• Treatments for Inflammation
▫ High-dose methyl prednisolone
• Treatments for Symptoms:
▫ Tremors-Clonazepam, primidone
▫ Fatigue-Amantadine, modafinil
• Treatments for Relapses:
▫ Holistic Multi-Professional Therapy
Future Treatments?
• Transplantation therapy:
Experimentally induce encephalomyelitis in mice
Neural stem cells from humans
Stem cell migrate
Improve of axonal loss
• Benedict RHB, Bobholz JH. 2007. Multiple sclerosis. Seminars in
Neurology 27 (1): 78-85.
• Compston A, Coles A. 2008. Multiple sclerosis. The Lancet 372
(9648): 1502-1517.
• Kulbatski I, Mothe AJ, Parr AM, Kim H, Kang CE, Bozkurt G, Tator
CH. 2008. Glial precursor cell transplantation therapy for
neurotrauma and multiple sclerosis 43 (3): 123-176.
• Vollmer T. 2007. The natural history of relapses of multiple sclerosis.
Journal of the Neurological Sciences 256 (1): S5-S13.
• Wakerley B, Nicholas R, Malik O. 2008. Multiple sclerosis. Medicine
36(12): 2008.
Study Questions
1. Why do lymphocytes not typically cross the blood-brain barrier?
A. There are low levels of MCH in the brain
B. Presence of immunosuppressive hormones and cytokines in the
C. Immune cells become anergized (Fas, FasL, and Treg) in the brain
D. A, B only
E. All of the above
2. Why do unmyelinated axons have a slower conduction of action potentials
than myelinated axons?
A. Myelinated axons only regenerate action potentials at the Nodes of
B. Unmyelinated axons only regenerate action potentials at the Nodes
of Ranvier
C. Myelinated axons regenerate action potentials at every ion channel
present along the axon
D. Unmyelinated axons regenerate action potentials at every ion
channel present along the axon
Study Questions (Cont.)
3. What is the role of β-arrestin 1, a protein responsible for regulating
receptor-mediated immune functions, in Multiple Sclerosis?
A. β-arrestin 1 is inhibited and therefore does not activate Th cells
B. β-arrestin 1 is over expressed and promotes constant activation of
Th cells
C. β-arrestin is involved with ineffective Th cell apoptosis upon
stimulation by self-antigens
D. Both B and C
4. Briefly explain why in patients with Multiple Sclerosis there is an immune
response against the myelin basic protein (MBP) even though it is a self