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REVIEW PAPER
Immunopathogenesis of multiple sclerosis – mechanisms of autoimmunity,
neuroinflammation and strategies of treatment
1
Student Research Group, Department and Clinic of Neurology, University Clinical Hospital No. 4, Medical University, Lublin, Poland
2
Student Scientific Association, Department of Pneumonology, Allergology, and Oncology, Medical University, Lublin, Poland
3
Department and Clinic of Neurology, University Clinical Hospital No. 4, Medical University, Lublin, Poland
Corresponding author
Filip Kazimierz Gajewski
Student Scientific Association at the Department of Pneumonology, Allergology, and Oncolog, Medical University, Doktora Kazimierza Jaczewskiego 8, 20-090 Lublin, Poland
Student Scientific Association at the Department of Pneumonology, Allergology, and Oncolog, Medical University, Doktora Kazimierza Jaczewskiego 8, 20-090 Lublin, Poland
KEYWORDS
multiple sclerosisimmunopathogenesisTh17 cellsregulatory T cells (Treg)B lymphocytesblood–brain barrierdemyelinationmicrogliadisease-modifying therapiesImmune tolerance / tolerogenic vaccines
TOPICS
ABSTRACT
Introduction and objective:
The aim of the review is to summarize current understanding of multiple sclerosis (MS) immunopathogenesis, focusing on Th17 cells, regulatory T cells, B lymphocytes, and innate immune components, while outlining contemporary and emerging therapeutic strategies
Review methods:
A literature search was conducted in PubMed and Scopus using the key words ‘multiple sclerosis’, ‘immunotherapy’, ‘autoimmunity’, ‘Th17 Cells’, and ‘B-Lymphocytes’ for publications occurring in publications between 2019–2025. A total of 412,560 articles were found – 173,450 were from PubMed and 239,110 from Scopus. After applying inclusion criteria to original research, reviews, book chapters, and editorials in English, 49 articles were selected for a narrative review. Over 96% of included studies were published within the last three years, reflecting a rapidly growing interest in the topic.
Brief description of the state of knowledge:
MS results from complex interactions among Th17 cells, regulatory T cells, B cells, microglia, macrophages, and astrocytes, leading to blood–brain barrier disruption, demyelination, axonal injury, and neurodegeneration. Therapeutic strategies have evolved from interferons and glatiramer acetate to oral agents, sphingosine-1-phosphate receptor modulators, monoclonal antibodies, and B-cell depleting therapies, enhancing disease control. Emerging approaches, including haematopoietic stem cell transplantation and peptide- or nanovaccine-based therapies, aim to restore immune tolerance with minimal systemic immunosuppression.
Summary:
MS arises from an imbalance between pro-inflammatory and regulatory immune mechanisms. Insights into these pathways have provided information about the development of targeted, individualized treatments. Further research into immune modulation and neuroprotection may enable durable remission, prevent neurodegeneration, and improve patient outcomes.
The aim of the review is to summarize current understanding of multiple sclerosis (MS) immunopathogenesis, focusing on Th17 cells, regulatory T cells, B lymphocytes, and innate immune components, while outlining contemporary and emerging therapeutic strategies
Review methods:
A literature search was conducted in PubMed and Scopus using the key words ‘multiple sclerosis’, ‘immunotherapy’, ‘autoimmunity’, ‘Th17 Cells’, and ‘B-Lymphocytes’ for publications occurring in publications between 2019–2025. A total of 412,560 articles were found – 173,450 were from PubMed and 239,110 from Scopus. After applying inclusion criteria to original research, reviews, book chapters, and editorials in English, 49 articles were selected for a narrative review. Over 96% of included studies were published within the last three years, reflecting a rapidly growing interest in the topic.
Brief description of the state of knowledge:
MS results from complex interactions among Th17 cells, regulatory T cells, B cells, microglia, macrophages, and astrocytes, leading to blood–brain barrier disruption, demyelination, axonal injury, and neurodegeneration. Therapeutic strategies have evolved from interferons and glatiramer acetate to oral agents, sphingosine-1-phosphate receptor modulators, monoclonal antibodies, and B-cell depleting therapies, enhancing disease control. Emerging approaches, including haematopoietic stem cell transplantation and peptide- or nanovaccine-based therapies, aim to restore immune tolerance with minimal systemic immunosuppression.
Summary:
MS arises from an imbalance between pro-inflammatory and regulatory immune mechanisms. Insights into these pathways have provided information about the development of targeted, individualized treatments. Further research into immune modulation and neuroprotection may enable durable remission, prevent neurodegeneration, and improve patient outcomes.
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