Immunological treatments in MS

Question 1

What are the typical MRI lesions in MS?

Answer 1

Large, periventricular, juxtacortical and infratentorial

Question 2

Describe the role of Th1/12 cells in MS.

Answer 2

Th1/17 reactivation –> cytokine secretion (IFN-gamma, TNF-alpha, IL-17/21-22) –> micorglia/astrocytes/macrophages activated –> cytokine secretion, augmented APC function

Question 3

Describe the role of CD8+ T cells in MS.

Answer 3

CD8+ T cell reactivation –> cytokine secretion (IL17, INF-gamma) + cytolytic granules –> axonal dissection

Question 4

Describe the role of B-cells in MS.

Answer 4

• B-reg dysfuntion inhibits the inhibition of effector T-cells –> active effector T-cells
• Cytokine activation of astrocytes and microglia

Question 5

What does the disease modifying therapies ocrelizumab, ofatumumab and rituximab do?

Answer 5

• Target B-cells: monoclonal anti-CD20 antibodies
• Induce apoptosis of B-cells by complement- and cell-mediated cytotoxicity

Question 6

Describe the immunopathogenesis of progressive MS.

Answer 6

• mt-DNA mutations and energy deficiencies –> mitochondrial injury
• Demyelination –> Fe3+ –> oxidative stress
• glutamate excitotoxicity –> ionic imbalance –> influx of Ca2+