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Immunological mechanisms involved in the pathogenesis of multiple sclerosis
OBJECTIVE. To summarize current knowledge of the immunological mechanisms involved in the pathogenesis of multiple sclerosis and its implications in the development of new therapeutic options. DEVELOPMENT. The aetiology of multiple sclerosis is still not completely clear. Nevertheless there is much evidence in favor of the possibility that autoimmune phenomena play an important part in the development and course of the disorder. Knowledge of the immunological phenomena involved determines the possibility of modifying the immune response at different levels. Thus it is possible to act on: 1. The trimolecular complex during lymphocyte activation. 2. To block the passage of activated cells across the blood-brain barrier. 3. To modify the effector action of specific antigen cells, and 4. Induce populations of regulator cells. Similarly, immunological phenomena which develop during pregnancy and the postpartum period are an interesting physiological model which permit identification of the mechanisms by which autoimmune disorders are modified. Amongst the factors affecting the immune response during pregnancy and the postpartum period the various maternal and foeto-placental hormones should be considered. Their actions may be due to their effects on the secretion of different groups of cytokines. Better understanding of the factors regulating the immune response during pregnancy and the postpartum period permits definition of new potential sites for therapeutic action.