Neurobiology and immunology are key areas of MS research, where researchers seek to understand the biological processes through which chronic inflammation leads to demyelination and neurodegeneration in the central nervous system.
Understanding these processes is key to developing new therapies to block inflammation and nerve cell damage, and to the discovery of ways to halt and reverse neurodegeneration.
An interesting example of how knowledge of the immune response in MS is evolving is the role of T helper cells. T helper lymphocytes activate other immune cells and direct them towards specific targets, and for some time it has been known that a specific subset of T helper cells (known as TH1 cells) plays an important role in central nervous system inflammation and the development of demyelinating lesions.
B cells are now recognised as playing a critical role in MS; this has become more evident recently with the advent of specific B-cell-depleting therapies. Other cells that participate in the immune response, such as monocytes and microglia, are currently being focused on actively in research, since they may have a central role in the pathogenesis of the disease.
In addition to demyelination, the importance of direct damage to axons and neuronal cell death is now recognised as a key factor in MS, particularly in progressive disease.
The extent of this neurodegeneration, and the processes through which it occurs, are now the subject of intense scrutiny, as blocking the abnormalities in ion transport and energy metabolism that lead to nerve cell death may help to prevent the build-up of disability.