Adaptative immunity and pathophysiology of multiple sclerosis

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS). The appearance of demyelinating patches in the CNS of patients with MS is associated with an inflammatory infiltrate mainly composed of macrophages and T lymphocytes. In this review, we focus on the evidence linking the development of the disease and the cell populations of the adaptative immune system. This evidence arises from anatomopathological, genetical and immunological studies, both on human and the animal model of the disease. Hence, we detail the implication of the effector lymphocytes, i.e. CD4(+) and CD8(+) T lymphocytes, but also B lymphocytes, in the disease. The implication of the regulatory T and B lymphocytes is also approached. Finally, the main hypotheses proposing an explanation to the development of MS are presented. (C) 2013 Published by Elsevier Masson SAS on behalf of the Societe nationale francaise de medecine interne (SNFMI).