Multipl Sklerozisin İmmünpatogenezi Kısım 1: Her plak aynı mıdır?

Year 2016, Volume: 69 Issue: 2, 75 - 80, 20.10.2016

Atay Vural , Aslı Tuncer , Rana Karabudak

Abstract

Neuroimmunological disorders came to the forefront in neurology in the past decade. Especially, our knowledge on multiple sclerosis, neuromyelitis optica and limbic encephalitis have massively grown and important diagnostic and therapeutic advances have been made. These disorders arise from the faulty interaction of the two most complex systems of human body: neurological and immune systems. Neurologists will encounter these disorders many times in a life timeand they will need an understanding of the immunopathogenesis in order to be able to treat such diseases. In this two-part review, we aim to increase knowledge of medical students, neurology residents and neurologists on neuroimmunology. We will try to do this by explaining immunopathogenesis of the prototypical disorder: multiple sclerosis. In thisfirst part, we will describe the types and histopathological characteristics of multiple sclerosis plaques and try to answer the intriguing question of why some patients with excessive number of lesions are in good clinical condition, while the others with lower plaque load have severe disease.

Keywords

Multiple Sclerosis , Pathogenesis , Immunology , Histology

Immüpatholegenesis of Multiple Sclerosis Part 1: Are all the plaques the same?

Abstract

Geçtiğimiz 10 yıl nörolojide nöroimmunolojik hastalıkların giderek ön plana çıktığı bir dönem olmuștur. Özellikle multipl sklerozis, nöromyelitis optika ve limbik ensefalitlerin immünpatogenezi hakkındaki bilgiler çok artmıș, söz konusu hastalıkların tanı ve tedavisiyle ilgili yeni tedaviler keșfedilmiștir. Nörolojik ve immün
sistem gibi vücudun en karmașık iki sisteminin hatalı etkileșmesi sonucu olușan bu hastalıklar tüm nöroloji uzmanlarının meslek hayatları boyunca pek çok kez karșılașacağı hastalıklardır. Bu hastaların bilinçli bir șekilde takiplerinin yapılabilmesi için, nörologların hastalık immünpatogenezleri hakkında bilgi sahibi olmaları elzemdir. İki kısımdan olușan bu derlemede, nöroimmünolojik hastalıkların prototipi olan multipl sklerozisin immünpatogenezi anlatılarak, tıp öğrencilerinin, nörolojiasistan ve uzmanlarının nöroimmünoloji bilgilerinin arttırılması hedeflenmiștir. Bu ilk kısımda, multipl skleroz plaklarının histopatolojik özelliklerinden bahsedilerek, MR görüntülemede lezyon yükü çok fazla olan bir kișinin klinik durumu çok iyi olabilirken, neden daha az sayıda lezyonu olan birinin kliniğinin çok daha ağır olabildiği gibi sorulara yanıt aranacaktır.

Keywords

Multipl Skleroz , Patogenez , İmmünoloji , Histoloji

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