With its diverse clinical picture and the cause that has not yet been fully understood, multiple sclerosis is still a mysterious disease that often frightens patients. However, thanks to modern diagnostics, MS can be detected at the first suspicion, so that the progression of the disease can be delayed for a long time with medication and those affected can enjoy a high quality of life.
As of today, the autoimmune disease is not curable, but it does not necessarily lead to a shortening of lifespan. The latest study results also show that there appear to be definable subtypes of multiple sclerosis that can be treated in a targeted manner and thus the treatment options can be significantly improved. Cause for the typical ones Multiple sclerosis symptoms are inflammations in the brain that are triggered by incorrectly programmed T cells, which multiply and attack the body’s own cells in the central nervous system.
Incorrectly programmed T cells overcome the blood-brain barrier
Multiple sclerosis is a chronic inflammatory autoimmune disease in which Immune cells attack the body’s own tissue – namely in the central nervous system, which is why the disease is considered a neurological disease. Incorrectly programmed T cells – a subgroup of lymphocytes (white blood cells) – manage to overcome the blood-brain barrier, which is supposed to protect the brain and spinal cord from pathogens and inflammatory cells. Exactly how the protective barrier is passed has not yet been fully clarified. What is certain, however, is that the T cells, which actually serve the immune defense against foreign pathogens, are directed against the body’s own body in multiple sclerosis.
In MS patients, the T cells mature incorrectly and, like “normal” T cells, do not recognize the body’s own tissue as such, but mistakenly consider it to be a dangerous pathogen. The target of these incorrectly programmed immune cells is the myelin sheaths of the nerve fibers in the brain. They ensure the insulation of the nerve fibers through the myelin layer and are significantly involved in the correct transmission of information via electricity between nerve cells. The attacks by T cells on the myelin sheaths of the nerve fibers trigger violent inflammatory reactions, as a result of which the insulating layers are destroyed and the electrical impulses are no longer transmitted correctly or not at all. These foci of inflammation can arise in all possible regions of the brain and impair the communication of the affected nerves with the corresponding organs in the body: inflammation of the optic nerve, for example, leads to the visual impairments typical of MS without there being any local inflammation of the eye.
Multiple sclerosis can develop in different forms. In the early stages, most patients experience a relapsing-remitting course with symptoms that begin suddenly and often subside without treatment, which later – sometimes only after many years – changes into the secondary progressive course: then the symptoms/disabilities develop after a while Relapse no longer completely recedes, but also worsens between acute relapses. A small proportion of those affected by MS have a primarily progressive course of the disease, in which the limitations in motor skills, for example, increase constantly from the start.
One new study by a research team at the University of Münster also shows that three subtypes of the disease known as multiple sclerosis can be distinguished at the cellular level. For the study, blood samples from over 500 patients in the early stages of the disease were examined. Three different types of immunological activation were identified, each of which was associated with specific characteristics and disease progression. MS not only leads to various clinical pictures, as has long been known, but also has a different pathogenesis, which is reflected in the immune cell profile of the patients. Accordingly, in the future, therapy can be tailored more closely to the individual requirements of one of the three subtypes in order to achieve greater effectiveness and better tolerability.
Multiple sclerosis: symptoms
Multiple sclerosis is also called the “disease with a thousand faces,” which indicates that those affected do not show a uniform clinical picture, but rather suffer from a variety of different symptoms. Depending on which nerves are affected, motor disorders, coordination disorders, vision, speech and sensory disorders as well as cognitive disorders can occur. The different symptoms can occur separately or together. Particularly feared symptoms of multiple sclerosis are muscle weakness and muscle cramps as well as pain in the affected muscle areas associated with loss of muscle strength. In combination, muscle weakness and spastic paralysis may require the use of a walking aid.
Good to know: Thanks to modern treatment options, a diagnosis of multiple sclerosis does not necessarily mean a severe disability. It is important that you contact a neurologist immediately when you first have symptoms and you suspect something, who will order examinations such as MRI and lumbar puncture as well as tests in order to be able to make a clear diagnosis. Multiple sclerosis symptoms that occur at the beginning of the disease include visual disturbances, problems walking and balance, and sensory disturbances such as tingling or numbness in the legs or arms.
The following symptoms are typical for multiple sclerosis:
- Visual disturbances (blurred vision, “hazy vision”)
- spastic paralysis symptoms (cramps and stiffness, especially of the legs)
- Sensation disorders (numbness, tingling, abnormal sensations)
- Gait disorders/unsteady gait (sometimes staggering gait, which is incorrectly interpreted as drunkenness)
- Balance disorders
- Coordination disorders (difficulty grasping, writing, etc.)
- Speech disorders (indistinct speech)
- Bladder disorders (imperative urge to urinate, bladder emptying disorders, incontinence)
- Swallowing disorders
- Fatigue (extreme exhaustion even with little exertion) in combination with a lack of recovery effect
- Pain of various kinds
- dizziness
- cognitive disorders (concentration, memory disorders, etc.)
- sexual dysfunction (such as loss of libido)
- Depression and anxiety (also as a result of symptoms experienced as threatening, due to a feeling of powerlessness in the face of the illness)
Multiple Sclerosis: Therapies
It can be assumed that due to new insights into the development of the disease, MS therapies will also change in the future in order to offer patients the most effective treatment options possible. Currently, in addition to symptomatic treatment with painkillers, the autoimmune disease is treated on the one hand in the short term with medication to treat an acute attack and on the other hand in the long term with course-modifying immunotherapy. In the latter case, an attempt is made to regulate the immune system, which is acting “uncontrollably”, with the aim of preventing future attacks. Depending on the severity of the disease, either immunomodulating drugs are used to influence the body’s own immune response or immunosuppressive drugs, which suppress the activity of the immune cells. Acute attacks are usually treated as shock therapy with cortisone, which inhibits the inflammatory processes. Cortisone has proven itself not only in multiple sclerosis, but also in a variety of other inflammatory autoimmune diseases and works quickly and reliably, but also has side effects. If cortisone therapy is not sufficient to provide the patient with adequate relief, blood washing may be indicated.
27. November 2024
