A NARRATIVE LITERATURE REVIEW ON THE PATHOPHYSIOLOGY OF MULTIPLE SCLEROSIS

Abstract

Multiple sclerosis (MS) is a complex and multifactorial disease that affects the central nervous system, characterized by inflammation, demyelination, and neurodegeneration. The pathogenesis involves the activation of self-reactive immune cells, including CD8+, CD4+ Th1, and Th17 cells, and the significant role of B cells, particularly related to the Epstein-Barr virus. Additionally, environmental factors such as EBV infection, vitamin D deficiency, obesity, and smoking contribute to MS. Oxidative stress, dysfunction in iron metabolism, and the intestinal microbiome also play crucial roles in the pathophysiology. The diversity in MS subtypes influences prognosis and treatment decisions. New therapies, including those targeting the microbiome and iron metabolism, show promising potential, challenging the traditional view of the disease and providing hope for effective treatment. However, issues such as the relationship between MS and neuropsychiatric disorders and therapeutic strategies require further in-depth studies to advance the understanding and management of this disabling disease.