19c. MS Flashcards
What is MS?
AI condition
Autoreactive
Inflammatory
Neurodegeneration
What happens in MS?
Immune cells infiltrate the BBB and attack the myelin sheath
What happens in MS if an attack is sustained?
Loss of oligodendrocytes
Neurodegeneration
What is the myelin sheath?
Fat and protein compound which wraps around a nerve to support nerve impulses
What is the myelin sheath made from?
Oligodendrocytes
What are the two types of MS?
Relapsing/remitting
Primary progressive
What happens during the relapsing/remitting form of MS?
Disease alternates between relapse/myelin loss and periods of remission
What happens during the primary progressive form of MS?
Continuous and progressive loss of neurological function with no remission
Symptoms of MS
Visual impairment
Nerve tingling/numbness
Intestinal/urinary problems
Fatigue/weakness
Poor co-ordination/balance
Speech difficulties
Difficulty walking
What is MS called if it only happens once?
Clinically isolated syndrome
What is MS called if it happens more than once?
Relapsing-remitting MS
Which gender is MS more prevalent in?
Female
Why is MS considered to be a T-cell mediated disease?
Shifts away from anti-inflammatory T-reg cells towards autoreactive Th17 T-cells
Causes and risk factors for MS (ACTIVE)
AI diseases
Cigarette smoke exposure
Trauma
Infections
Vit D deficiency
Environmental toxins
Why is vit D deficiency a risk factor for MS?
MS more prevalent in countries away from equator
Vit D helps shift autoreactive T-cells towards anti-inflammatory T-reg cells
Which other vitamins are found to be deficient in MS (other than vit D)?
K
B12
Why is a vit K deficiency a risk factor for MS?
Vit K needed for Gas 6
What is Gas 6?
Vit K dependent anti-inflammatory protein
Protects oligodendrocytes
Promotes remyelination
Why are MS patients thought to be low in vit K?
Poor microbial synthesis in gut
Low absorption
Low dietary intake
Why is a B12 deficiency a risk factor for MS?
Phospholipids in myelin sheath are methylated
Need B12 to support methylation
Improves neuron growth
Regenerates myelin sheath
Why is obesity a risk factor for MS?
Obesity makes the BBB more permeable leading to CNS inflammation
Leptin - raised during obesity - associated with CNS inflammation
Obesity leads to upregulation of M1
Why is leptin associated with CNS inflammation?
Increases levels of Th17 autoreactive T-cells
Why is childhood trauma a risk factor for MS?
Leads to thymic involution or atrophy
Amplifies production of Th17 cells
Negative impact on oligodendrocytes
How does stress affect inflammation?
SNS and PSNS parts of ANS regulate inflammation by interacting with T-cells
Chronic stress undermines ANS connection to T-cells and drives inflammation
