Multiple Sclerosis is an autoimmune disease of the central nervous system.  What this means is that the person’s own immune cells (white blood cells) are attacking the nerves of the brain and spinal column.  MS causes inflammatory demyelination: it specifically attacks the myelin (protective coating) surrounding the nerves and causes inflammation.  Without the myelin, these weakened nerves cannot carry messages well, and can even break.  Basically, any function in the body that is controlled by the nerves (which is all of them) can be affected.

            Let’s try to break this down and explain a little more.  The first question that came to my mind is “How?”  The blood brain barrier’s job is to keep larger cells from getting into the brain.  The cell walls of the blood vessels in the CNS are tighter than elsewhere in the body.  This means that there has to be a breakdown of the BBB in order for the large immune cells to get past it.  I’m not quite sure yet what causes this to happen.

            The second question is “Why?”  The immune cells develop along with the other cells of the body.  All cells have receptors (antigens) on them so that the immune cells will know that they belong to that body and are not an invader.  So, why are they picking on myelin?  It is thought that these cells may develop after the BBB has already formed, so the immune cells don’t get the chance to become acquainted with them.  The immune cells, specifically the T-cells, are very good at their job.  Not only do they go in and destroy the “invaders” that they find, but they also call in reinforcements.  Their call signals, called cytokines, help with both of these functions.

            So, we have immune cells where they’re not supposed to be and they’re attacking cells just because they don’t know them.  But, why is this causing problems all-over the body?  The answer is in the way the nerves work.  Think of nerves like telephone wires.  A message is put in at one end and carried to the other.  This works in both directions, just using parallel wires.  If there is interference in one wire, it shorts-out.  You may not be able to hear the person on the other end, but they could hear you just fine.  The body works the same way.  The brain literally “short-circuits” and it either prevents the brain from transmitting or receiving messages.  The areas that have been attacked are called plaques or lesions, and on an MRI scan they look like little circles that have been whited-out.

            The good thing is that the effects of this damage need not be permanent.  Steroids can be administered to quiet the immune response.  The other drugs used to treat MS also work to activate cells that will stop this response and try to strengthen the BBB.  Some of the myelin will repair its self, a process which can be aided by dietary changes or supplements.  The only thing that cannot be helped is broken nerves.  Nerve cells don’t usually grow back.  Over time, multiple broken nerves will curl-up on themselves and give the appearance of brain atrophy (shrinkage).

            MS attacks women compared to men at a ratio of 4 to 1.  This could be due to a difference in hormone levels, which is being investigated.  Another reason for this belief is because of what happens during pregnancy.  For women with MS and some other autoimmune diseases, the progression of the disease stops while pregnant.  Of course, any damage that has already happened will remain, but there will be no further attacks.  This is really good, since you wouldn’t want to be on the medication then anyways.  The down-side to this is that shortly after delivery, about two weeks later, the disease comes back full-force.  This can be delayed or slowed my breast feeding, but not completely.

            There are 5 primary drugs on the market to treat MS.  Some work slightly different from the others, and they all carry their own side-effects.  There are new drugs in clinical trials at the moment, including some that can be taken orally.  This is great news for two reasons: 1) All of the current therapies are given via injection, either intramuscular (hurts like heck!), subcutaneous (feels like a bee sting), or intravenous (IV-enough said); and 2) Over time the body developes an immunity to the medicine, or the person may have a reaction to it, or it might just not work for that person.  Anyway you look at it, new treatment options are always good…and this makes all of us needle-phobics in the world rejoice!  Not to mention that the current “last” option is either steroids in combination with one of the other drugs, or chemotherapy.  I, for one, prefer to not gain a grotesque amount of weight or lose anymore of my hair!