daniele

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Multiple sclerosis (MS) is an autoimmune disease which target the myelinated central nervous system (CNS) tracts. Multiple sclerosis (MS) is the most common chronic inflammatory demyelinating disorder of the CNS, and the leading cause of non-traumatic neurological disability in young adults, affecting 0.1% of the general population in Western countries (Noseworthy et al., 2000). There are many risk factors that could be considered responsible of the pathology; First, an environmental risk factor such as infections such as measles and Epstein–Barr virus; climate and solar conditions; living conditions; diet and trace elements (Rosati, 2001). The inflammation damages the blood–brain barrier, induces the destruction of myelinand consequently of the axon damage, gliosis and the formation of sclerotic plaques (Nylander and Hafler, 2012). Continuing lesion formation in MS often leads to physical disability and, often, to cognitive decline. Also the course of the disease is variegated with people that are not affected and more that 60% that loses the ambulatory capability 20 years after the onset. Almost 80% of patients will initially present unpredictable attacks (relapses), with variable duration, in which new symptoms appear or existing symptoms become more severe. At the end of the attack there is a partial or complete recovery. However, symptoms may become more severe and the recovery of function less complete after each attack (Luessi et al., 2012). No curative therapy is currently available, on the other hand, therapies are mainly directed to protect CNS cells, modulate T cells, and induce remyelination. Interferon (IFN)-β was the first agent to show clinical efficacy in the most common form of MS, i.e., relapsing -remitting MS. ... ... middle of paper ... ...d mechanistic. For instance the interval of age of the onset and progression of the disease is outspread; even when the same type of mutation is present, the age at onset and survival vary substantially (Regal et al., 2006). This heterogeneity remains at the moment unexplored and misunderstood (Van Damme et al., 2013). Drugs have little effect on disease progression, and thus input from multidisciplinary teams, artificial ventilation, and feeding tubes are the main care options. It was recently suggested that also cognitive functions (including emotional lability) are affected because of this disease (Abrahams et al., 1995). The only drug approved by the Food and Drug Administration for the treatment of ALS is riluzole, a glutamate antagonist. In two therapeutic trials, riluzole prolonged survival by three to six months (Bensimon et al., 1994;Lacomblez et al., 1996).

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