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ALL ABOUT MS What is multiple sclerosis (MS) (Part 1)

What is MS?

Multiple sclerosis (Sclerosis multiplex, Enchephalomelitis disseminate), abbreviated MS, is an immune disease, involves axons, long nerve cell prolongations, on which some parts of the myelin coat are reacting and failing inflammation. Therefore, multiple sclerosis is considered an inflammatory, demyelinating disease caused by immunological changes of unknown aetiology. When a certain part of the myelin sheath is inflamed and damaged, the transmission of the impulse through the axon is disturbed, slowed or interrupted, resulting in messages from the brain coming to the "target" with delay, "errors" or none (absent). The disease is a very variable flow, is expressed by neurological symptoms and signs, and is characterized by frequent deterioration of varying degrees, which shifts with rapid improvement of the clinical picture (remission of the disease). The onset of multiple sclerosis is accompanied by many disorders of varying degrees, from mild stiffness and difficulty to walking, to complete seizure, blindness, etc.


Since when we know about MS?

The first descriptions of the brain of a person with MS originate from Karswell and Kruveljea, which they gave in the first half of the 19th century. Connection between brain changes and clinical symptoms that are appear in MS for the first time was clearly defined by the French neurologist Jean Martin Sharko in 1868. Since 1878, when Rawley discovered the myelin, to this day, it's constantly there is new knowledge that approaches us with a the solution of the enigma represented by MS.
Who gets?

MS is most commonly diagnosed in people between 20 and 40 years of age, usually at a time when the most- higher family and professional obligations. The disease is rare discovered before 15 years of age, while her performance after 55. The year of life is very rare. Women get sick more often than men, in the ratio of about 2: 1. The frequency of disease varies in different parts of the world, and even within a single country. The disease is more common in countries that are housed between 40th and 65th degrees of northern latitude, it is very rare in the tropics and in the Far East.


MS has an impact on the entire family, as many family members are caring for patients, usually without proper support. However, it is important to know that many patients after the onset of the first symptoms appear capable of working and most of them can continue productive and happy life. Of those who have a diagnosis, 75% will never need a wheelchair, and most patients can expect a normal long life. A very small percentage of patients are susceptible to disease after several years due to developing complications such as pulmonary inflammation or chronic kidney failure with cessation of work. This small percentage of patients is getting smaller as our knowledge grows and how new methods of treating MS are increasingly applied. MS has a better prognosis than is considered: half the patients have a benign course of the disease with a duration of 30 years or longer. The average duration of the illness is 20-25 years, after which about a third of the patients are fully capable of working, especially for home affairs.

Cause of disease

The cause of MS is unknown, but it is considered that the disease results under the influence of an unknown environmental factor (viruses, bacteria, nutrition factors) in genetically susceptible persons.



There was an idea that MS was caused by some toxic agent. After detailed testing of air, salt, water and food, no agent was identified that would be a potential cause of MS. Other possible causes, which are no longer considered plausible, include vascular abnormalities (blood circulation disorder), metabolic disorders (internal chemical abnormalities such as hormone or enzymatic disorders, blood sugar levels), congenital (the existence of disease from birth) and psychological (psychological changes that would cause organ failure) disorders and tumors.

Probable causes of MS

The likely causes of multiple sclerosis today include:
  • heredity (genetic predisposition),
  • infection (specific, slow-acting virus or bacteria that remain hidden in the body for many years), and
  • allergic events in the body itself.

Heritage

Although MS is not a hereditary disease, i.e. is not transmitted from one generation to the next, there is a certain inherent tendency to develop the disease. The next propensity for MS increases for an individual if a family member has a sick member. However, 80% of MS sufferers do not have close relatives who suffer from the same disease. Approximately 10% of patients in their near or far relatives have a MS patient.


If one of the twins is ill, the chance of getting rough and others is about 30% for one-off, and in the case of twin twins, the likelihood is lowered to 4%, as in the case of non-blond brothers and sisters. In the case of relatives of the second and third degree, the risk of MS is about 1%.
Most of today's theories point out that MS is caused acting multiple genes.

Infection

MS is not an infectious disease in the sense that the patient can be transferred to someone in his family or environment.
The most popular hypothesis is that a viral infection at one time instigates a sensitive immune system to an abnormal reaction later in life. At the molecular level, this is only possible if there is a structural similarity between the virus and some component of the central nervous system, which would possibly causing confusion in the immune system.


In the blood of patients with MS, high levels of antiviral antibodies are regularly found, and often different parts of viral organisms are found, as are other signs of viral infection. However, the specific virus is directly linked with MS not yet identified. Over the past 50 years, in cerebrospinal fluid (a fluid flowing through and around the brain and spinal cord, and primarily has a protective function) of patients with MS, various studies have found more than 10 types of antibodies. Most patients have at least one type of antiviral antibody, often and more.
However, in patients with MS, the immune system is hyperactive, i.e. it overreacts to dead viruses, as opposed to those in whom the immune system is properly regulated, so it is not clear whether the presence of antibodies in the liquor is a cause or effect.

Trauma

The idea that injuries or stress could lead to symptoms of MS or even begin its exacerbation has long been a subject of discussion between researchers, doctors and patients. Many research was carried out in an attempt to further illuminate this theory. In most cases, the results have not confirmed this hypothesis, although most patients will still confirm the onset or worsening of the symptoms after greater trauma or stress.

The environment

Since MS seems more common in people living far from the equator, there is a theory that reduced exposure to sunlight and possibly reduced vitamin D production can help in the emergence of multiple sclerosis. This terrier is supported by new research that shows that vitamin D is an important regulator in the immune system.

The role of the immune system and allergic reactions in the onset of MS

Most researchers believe that MS is an "autoimmune disease", i.e. a disease in which white blood cells, very important units of the immune system that an organism produces to neutralize foreign bodies that can cause infection or illness, attack the cells of their own organism. Namely, exacerbation of MS begins when myelin inflammation; This inflammation area is called lesion. White blood cells are released from the blood and begin to attack that myelin.


The new myelin is normally produced by young oligodendroids, which develop from the so-called. stem cells that disappear with age. Mature oligodendroids do not have the ability to share or replace. Without young oligodendrocytes or stem cells that produce myelin, remeligation is often slow and incomplete.

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