Multiple Sclerosis Analysis Essay Example

people typically experience their first symptoms of MS between the ages of 20 and 40; however, diagnosis often gets delayed due to the transient nature of the disease and lack of a specific diagnostic test. Confirmation requires specific symptoms and changes in the brain to occur. Although there have been documented cases in young children and elderly adults, symptoms rarely appear before age 15 or after age 60.

Among different races, Whites have more than double the likelihood of developing MS compared to other races. Women are generally affected at nearly twice the rate as men; however, among patients who develop symptoms later in life, gender balance is observed.

To understand multiple sclerosis (MS) in individuals, it is important to have knowledge about the functioning of a healthy immune system. The immune system serves as a defense mechanism for the body and consists of a complex network of specialized cells and organs.The immune system's primary function is to protect the body from bacteria, viruses, fungi, parasites, and other foreign invaders by identifying and eliminating them. Antigens are substances that can trigger an immune response. The immune system shows great diversity and specificity in recognizing millions of unique foreign molecules and generating its own molecules and cells to counteract each specific invader. To handle the various potential foreign invaders, the immune system stores only a small number of cells for each specific antigen. When an antigen is present, these matched cells are stimulated to multiply into a larger group; however, mechanisms exist to prevent excessive expansion of this army.

In multiple sclerosis (MS), T-cells play a significant role after being processed in the thymus gland. These T-cells travel throughout

the body on patrol duty for foreign invaders. Each T cell's surface has special receptor molecules that allow them to identify and respond to specific antigens. T-cells contribute to the body's defenses through two methods: regulatory T cells coordinate the immune system while assisting other cells in producing antibodies targeting specific antigens; Helper T cells have a vital role in activating the body's defenses against foreign substances. There is also another subset of regulatory T cells that suppress different immune system cells once their task is complete.Killer T cells directly attack damaged body cells by binding to them and bombarding them with cytokines. These T cells must distinguish between "self" cells and "nonself" cells, which is aided by identifying molecules on the surface of each body cell. Some self-reacting T cells are eliminated in the thymus, while the remaining T cells peacefully coexist with body tissues through self-tolerance. However, conditions like multiple sclerosis (MS) cause a dysfunctional immune system that mistakenly identifies self as nonself and attacks the myelin sheath of nerves. Scientists are studying MS patients' immune systems to understand these mechanisms. Myelin components like myelin basic protein have received attention in studies because they can induce an MS-like disease when injected into animals. This injection likely stimulates production of anti-myelin T cells that attack their own myelin. Researchers at Leuven are currently studying abnormalities or malfunctions in the blood-brain barrier, which regulates substance passage from blood to central nervous system. In MS, it is believed that parts of the immune system breach this barrier and damage the nervous system.Investigations have been conducted on various infectious agents, including viruses, as potential causes of MS.

However, no specific agent has been identified thus far. Viral infections typically lead to inflammation and the production of gamma interferon, a chemical that can exacerbate MS symptoms. The immune response to viral infections may also trigger an MS attack. Genetic makeup may also contribute to an individual's risk of developing MS. While there is evidence supporting a genetic component in MS, it is just one factor among others. Ultimately, an individual's genetic blueprint likely determines their susceptibility to a triggering factor that initiates the autoimmune process leading to the development of MS (Melvin).

In recent years, scientists have developed molecular genetics tools that enable them to identify specific genetic factors that contribute to an individual's susceptibility to MS. These tools were initially used in the 1980s for studying human diseases caused by single gene defects, resulting in advancements in understanding conditions such as Duchenne muscular dystrophy and cystic fibrosis. It is now believed that only individuals who inherit a specific combination of genes are susceptible to diseases like multiple sclerosis.

Thanks to advances in molecular genetics and the identification of large families affected by multiple sclerosis, researchers have been able to search for these susceptibility genes since 1991 through an international project supported by the National MS Society.Although the development of MS is influenced by genetic factors, no specific gene has been identified yet. Instead, scientists believe that MS is caused by a combination of multiple genes. Researchers are conducting studies with multiplex families from around the world to search for consistently inherited DNA markers associated with MS. These markers help determine the location of genes that contribute to MS, allowing further investigation into additional markers

closer to the gene until its exact location is known. This process is repeated for each marker region.

By 1996, about 20 potential gene locations for MS had been identified, but none had a significant impact on susceptibility. Research suggests that there may be other unidentified genes involved in MS as well. Once the location of each susceptibility gene is determined, further studies must be conducted to understand its role in both the immune system and neural aspects of MS patients.

The close connection between the immune system and MS implies that susceptibility genes may play a significant role. Some research has already found links between immune system genes and MS, and familial studies have shown a higher occurrence of specific gene regions among those with MS. One example is the human leukocyte antigen (HLA) region on chromosome 6, which affects the immune system. The HLA patterns observed in individuals with MS differ from those without the disease.Studies conducted in northern Europe and America have found that three HLAs are more common in individuals with MS compared to the general population. Furthermore, American MS patients tend to have higher rates of combinations of these HLAs. Different combinations of these HLAs may correspond to variations in disease severity and progression. Research on families with multiple cases of MS and comparisons between genetic regions affected by EAE in humans and mice suggest that there may be another area on chromosome 5 associated with susceptibility for MS. Other gene-containing regions on chromosomes 2, 3, 7, 11, 17, 19, and X also support the idea that multiple factors influence the development of MS instead of a single gene or agent. The

interactions between several genes likely play a role in the development of MS, with each gene individually having only a modest effect. More research is needed to identify the specific genes involved in MS and understand their function and interaction with other genes and the environment in making individuals susceptible to the disease. These studies can improve MS diagnosis, provide insights into its underlying causes, enhance treatment methods, and potentially even lead to preventive measures.Discovering the genes responsible for MS susceptibility may also help predict disease progression in individual patients and enable tailored therapies and life guidance based on this information. Early diagnosis in families with an MS history could offer potential benefits as many doctors believe starting treatment promptly after diagnosis improves outcomes. The symptoms of MS can vary in severity, duration, and combination depending on which part of the nervous system is affected. Interestingly, approximately 70 percent of patients with MS experience either complete or partial relief from symptoms, especially in the early stages.
In the initial phase of MS, common symptoms include blurred or double vision, red-green color distortion, and potential blindness in one eye (Brunnscheiler). It's worth noting that visual issues tend to improve as MS progresses. Inflammation affecting the optic nerve can be diagnosed as retrobulbar or optic neuritis.Optic neuritis is experienced by about 55 percent of MS patients at some point and serves as an early indication of MS for around 15 percent, particularly if abnormalities are detected during spinal fluid tests (National Multiple Sclerosis Society).
As the disease progresses, most individuals with MS will encounter muscle weakness in their extremities along with difficulties in coordination and balance that may hinder

walking or standing.Severe cases can lead to partial or complete paralysis.The text discusses various symptoms and manifestations of multiple sclerosis (MS) along with its impact on cognitive abilities. and their contents are maintained. Additionally, spasticity - characterized by involuntary stiffness and spasms caused by increased muscle tone - is a common symptom (Brunnscheiler). Fatigue also affects many patients with MS and can be triggered by physical exertion but alleviated through rest. Many individuals with MS may also experience constant tiredness. They may encounter temporary abnormal sensory feelings such as numbness, prickling, or "pins and needles" sensations known as paresthesias. Pain can occur in rare cases as well. Sensation loss is also possible. Speech impediments, tremors, and dizziness are common symptoms in people with MS. There might be occasional hearing loss too.

Approximately half of individuals with MS experience cognitive impairments that include difficulties with concentration, attention, memory, and judgment but are often mild and easily overlooked.Comprehensive testing is usually necessary to detect these impairments since patients themselves may not be aware of their cognitive loss initially; it is often a family member or friend who first notices a deficit.However,cognitive impairments are typically mildand rarely disabling leaving intellectual and language abilities unaffected.These impairments occur due to lesions developing in brain areas responsible for information processingThe effects of altered cognition in MS become more apparent when dealing with complex information and can worsen due to fatigue. The exact cause of this cognitive alteration remains unknown. It is uncertain whether the problems are related to information acquisition, retrieval, or a combination of both. The specific type of memory issues may vary depending on the person's disease progression. However,

according to the National Multiple Sclerosis Society, there is no direct correlation between how long someone has been ill and the severity of cognitive dysfunction.

Depression, commonly seen in individuals with MS, does not have any connection to cognitive problems. Additionally, around 10 percent of patients may experience more severe psychotic disorders such as manic-depression and paranoia. Another five percent might have episodes of inappropriate euphoria and despair known as "laughing/weeping syndrome." This syndrome is unrelated to their actual emotional state and is believed to be caused by demyelination in the brainstem area that controls facial expression and emotions. It tends to be observed in severe cases.

As multiple sclerosis progresses, sexual dysfunction can occur along with a risk of losing control over bowel and bladder functions according to Health Central. For approximately 60 percent of MS patients, external temperatures or exercise can temporarily worsen many symptoms; however, eliminating heat resolves this issue for these individuals.The National Multiple Sclerosis Society recommends that temperature-sensitive patients find temporary relief from symptoms by taking a cold bath. Swimming is often recommended for individuals with MS due to its sensitivity to temperature, according to Wenzel. The symptoms of MS can have a significant impact on the entire family, including an inability for patients to work and increased medical expenses and costs for assistance with housekeeping and home and vehicle modifications. Counseling can provide support in dealing with the emotional toll on patients and their families. While there is no cure for MS, some patients may not require therapy due to serious side effects and risks associated with certain medications. The presence of spontaneous remissions makes it challenging to determine the effectiveness

of experimental treatments; however, MRI scans can be useful in evaluating new therapies by tracking lesion development. In the past, doctors primarily used anti-inflammatory steroids like ACTH, prednisone, prednisolone, methylprednisolone, betamethasone, and dexamethasone for treating MS. Research suggests that intravenous methylprednisolone may be more effective than traditional intravenous ACTH for acute relapses. There is no strong evidence supporting the use of these drugs for progressive forms of MSSteroids may be more suitable for individuals with movement symptoms than sensory symptoms, as they can reduce the severity and duration of attacks in certain MS patients. However, their long-term impact on the course of the disease is still unknown. One study suggests that steroids may benefit MS treatment by restoring the effectiveness of the blood/brain barrier. Nonetheless, due to adverse side effects such as acne, weight gain, seizures, and psychosis, long-term use of steroids is not recommended.

In terms of promising research in MS treatment, interferons are being explored. Beta interferon forms like Avonex and Betaseron have gained FDA approval for treating relapsing-remitting MS. Rebif is available in Europe. MRI scans conducted at Mayo Clinic have demonstrated that beta interferon can decrease both the frequency and severity of exacerbations while also slowing physical disability progression and reducing myelin destruction. Researchers believe this effect could be attributed to its ability to correct a deficiency of specific white blood cells responsible for suppressing the immune system or its capability to inhibit gamma interferon thought to contribute to MS attacks.

Mayo Clinic is currently studying alpha interferon as a potential treatment for multiple sclerosis (MS). It's important to note that despite their potential benefits, interferons commonly cause side effects such as fever,

chills, sweating, muscle aches, fatigue depression,and reactions at the injection site.Despite the side effects, scientists are persisting in their efforts to develop improved therapies for Multiple Sclerosis (MS). The goals of MS therapy include enhancing recovery from attacks, preventing or reducing relapses, and stopping disease progression. However, MS remains a well-known but poorly understood disease among both the medical community and the general public. Currently, there is no cure for MS and the genes responsible for it have not been identified yet. Nevertheless, with time, money, faith, and determination invested in understanding its significance, the United States has the potential to discover a cure.

It should be noted that antibodies are proteins produced by the immune system that bind to foreign structures recognized as antigens by the body. Antigens refer to foreign structures like viruses recognized by the body's immune system. Ataxia refers to impaired muscle coordination while an autoimmune disease occurs when the body's defense system mistakenly attacks its own tissues instead of foreign substances. The blood/brain barrier acts as a membrane controlling which substances can pass from the blood into the central nervous system.

Cerebrospinal fluid (CSF), a clear liquid found in the brain and spinal cord, consists of substances filtered from the blood and secretions released by brain cells.Physicians utilize a range of tests, including electrophoresis, isoelectric focusing, capillary isotachophoresis, and radioimmunoassay, to examine cerebrospinal fluid (CSF) for abnormalities associated with multiple sclerosis (MS). Cytokines, powerful chemical substances released by T cells that play a significant role in inflammation, have potential as treatments for MS. Demyelination refers to the damage caused to myelin due to recurrent inflammation attacks. This damage ultimately leads to scars

called plaques in the nervous system, disrupting communication between nerves and the rest of the body. Experimental allergic encephalomyelitis (EAE), induced in laboratory animals through injection of myelin basic protein, is a chronic brain and spinal cord disease similar to MS. Fatigue can occur during activity or persist without exertion and is characterized by a feeling of tiredness. Gadolinium, a chemical compound administered during MRI scans, helps distinguish between new and old lesions. Human leukocyte antigens (HLAs), also known as major histocompatibility complex genes, control immune responses that are tolerated by the body. Immunoglobulin G (IgG), produced by plasma cells in central nervous system plaques in individuals with diseases, contains antibodies. Most MS patients have elevated levels of IgG in their CSF. Immunosuppressants are medications being studied for MS treatment that suppress functions within the immune system.Interferons, a group of antiviral proteins classified as cytokines, have varying effects on Multiple Sclerosis (MS) symptoms. Gamma interferon exacerbates MS symptoms by increasing T-cell recognition of antigens, while alpha and beta interferon are likely beneficial for MS treatment as they suppress the immune system. Lesions refer to abnormal changes in an organ's structure caused by disease or injury. Magnetic Resonance Imaging (MRI) enables researchers to non-invasively observe and monitor the development of MS lesions. Myelin is a fatty covering that insulates nerve cell fibers in the brain and spinal cord, facilitating smooth transmission of electrochemical messages between these components of the central nervous system and the rest of the body. Demyelination occurs when myelin becomes damaged, leading to distorted or blocked signals—a common occurrence in MS patients resulting in high levels of myelin basic protein (MBP) in their

cerebrospinal fluid. Injecting MBP into laboratory animals can induce experimental allergic encephalomyelitis, a chronic brain and spinal cord disease similar to MS. Oligodendrocytes play a crucial role in producing and maintaining myelin. Optic neuritis, an inflammatory disorder affecting the optic nerve that can cause temporary visual loss or blindness, is commonly associated with Multiple Sclerosis (MS). Individuals with MS often experience abnormal sensations like numbness or tingling known as paresthesias.The text discusses various aspects of Multiple Sclerosis (MS) and related conditions. Plaques, which are characterized by inflammation and demyelination, disrupt normal nerve signals in affected areas. Antigens are identified by cell surface receptors. Retrobulbar neuritis is a temporary inflammatory condition that affects the optic nerve and causes rapid vision loss and potential eye pain during movement. Spasticity affects the lower limbs in people with MS, resulting in involuntary muscle contractions, spasms, stiffness, or rigidity. Research suggests that T cells, immune system cells developed in the thymus gland, play a role in myelin destruction. Transverse myelitis is a sudden acute spinal cord disorder presenting as low back pain, muscle weakness, and abnormal sensory sensations in the lower extremities. While most cases resolve on their own, severe or long-lasting cases can lead to permanent disability. MS lesions occur beneath the gray matter of the brain and white matter of the spinal cord.

Bibliography:
- Bernard, Bobby.Multiple Sclerosis Continues to Puzzle Scientists.The Vermillion March 1998
- The first source is an article by Brunnscheiler titled "Problems Associated with MS" published on July 28,
1999 available on Inteli Health's website (http://www.intelihealth.com/) accessed on same date.
- The second source is a journal article by Kathleen M. Boyden discussing the use of Compolmer-1 in treating

Multiple Sclerosis.