Jack Antel
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what is ms
a cns demyelinating disease associated with inflammation, demyalination, and concurent loss of axoms
what is the ms disease course
-acute -chronic active -chronic
relapse contribute to the accumulation of what
-disability, primarily early in ms
what is pira
progression in absence of relapse activity
when does pira start
in relapsing remitting ms
what becomes the dominant driver of disability in ms as the disease evolves
pira
what are the principal risk factors for further disability accumulation
pre existing disability and an older age
true or false: the use of disease modifying therapies delays disability accrual by months
false, by years -with the potential to gain time being the highest in the earliest stages of ms
what is the prevalence of ms
100/ 100 000 in european descended populations
true or false: asians also can get ms
true, western type ms in asians when they move to the west
what is the age of onset of ms
30-40yrs
what is the ratio of men vs women having ms
either 3 or 2: 1 -increasing -reduced activity in pregnancy
Familial aggregation is determined by….
genes -population risk is strongly influenced by environments
Concordance rate in monozygotic female twins is for ms
35% vs 1-2% in discordant twins
rr ms: common factors among autoimmune diseases
hls-dr region more than 250 weak association
for progressive ms what are the genetic factors
distinct cns related genes
what are the enviromental risk factors for ms
-ebv exposure -vitamin d -microbiome -smoking -western diet
Clonally expanded B cells in multiple sclerosis bind what
EBV EBNA1 and GlialCAM
Cross-reactive EBNA1 immunity targets what
alpha-crystallin B and is associated with multiple sclerosis
Ineffective control of Epstein-Barr-virus-induced autoimmunity increases risk for what
ms
Siblings reduce multiple sclerosis risk by preventing
delayed primary ebv infection
The first neuro-immunologic observation made over a century ago was of …
paralytic encephalomyelitis in patients receiving injections of Pasteurs’ new rabies vaccine
Post vaccination encephalomyelitis, what happened
that not only has Pasteur’s method “increased the number of deaths from hydrophobia”, but that “there has been added to these a large number of deaths due to inoculations of what ought to be called Pasteur’s disease”
what are the koch postulate
-Presence of agent/immune mediator(s) at site of pathology -Agent/immune mediator(s) present only in those with the disease -Agent/immune mediator(s) can be used to transfer the disease -Removal of agent/mediator(s) have therapeutic effects