TY - CHAP M1 - Book, Section TI - Chapter 41. Multiple Sclerosis A1 - Egeberg, Michael D. A1 - Bainbridge, Jacquelyn L. A1 - Clark, Jeffrey K. A2 - Attridge, Rebecca L. A2 - Miller, Monica L. A2 - Moote, Rebecca A2 - Ryan, Laurajo Y1 - 2013 N1 - T2 - Internal Medicine: A Guide to Clinical Therapeutics AB - Degradation of myelin sheath surrounding axons in CNSInflammatory process mediated by T & B ymphocytes, antibodies, macrophages, & complement (N Engl J Med 2006;354:942) Activated peripheral T cells activate matrix metalloproteinases → disrupt BBB → entry to CNSCytokines released in CNS cause upregulation of immune response → damage to myelin sheathCytokines primarily involved in the inflammatory process include tumor necrosis factor-α, interferon-γ, & interleukins-1, -2, -12, -17, & -23 (Ann Neurol 1994;36:S6)Demyelination leaves neurons vulnerable to damage; if neurons severed → irreversible; appears on T1-weighted MRI as a hypointense lesion or “black hole” (N Engl J Med 1998;338:278) SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accesspharmacy.mhmedical.com/content.aspx?aid=57294528 ER -