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Book and Media Review
November 2013

Review of The Biology of Multiple Sclerosis

Author Affiliations
  • 1Department of Neurology, University of Texas Southwestern Medical Center, Dallas
JAMA Neurol. 2013;70(11):1461. doi:10.1001/jamaneurol.2013.4266

The Biology of Multiple Sclerosis
Gregory Atkins, Sandra Amor, Jean Fletcher, Kingston Mills
139 pp, $80, ISBN 978-0521196802, New York, New York, Cambridge University Press, 2012.

Multiple sclerosis (MS) is the most common cause of neurological disability in young adults. The past 2 decades have witnessed an ever-increasing number of promising treatments for this potentially debilitating condition, mainly owing to an improved understanding of its pathobiology. Despite the tremendous amount of research that has been performed, the primary cause of MS is still unknown.

The Biology of Multiple Sclerosis provides a concise, up-to-date review of the literature on different theories of MS pathogenesis. The authors have nicely summarized the available information about the different aspects of the pathophysiology of the disease that has been (and will be) the foundation of clinical progress in the diagnosis and treatment of MS. The first chapter is an overview of the disease and the environmental and genetic factors affecting its development. This chapter lays the groundwork for the chapters that follow. The neuropathology of MS is discussed in the second chapter. The pathological subtypes of MS, the staging and evolution of lesions, gray matter lesions, axonal damage, and neurodegeneration are among the topics reviewed in this chapter. Considering the importance of the experimental autoimmune encephalomyelitis (EAE) model in the elucidation of the mechanisms of neuroinflammation and in the development of new therapies for MS, the third chapter is devoted to EAE and its induction with different autoantigens in different animal models, immunization protocols, and the pathology and immune mechanisms involved in the pathogenesis and provides guidelines for using, reporting, and reviewing EAE studies. The immunology of MS, including the role that different cells play in innate and adaptive immune systems and the current and emerging immunotherapies for MS, is covered in the fourth chapter. Besides the EAE model, there are several less well-known models that use viral infection of inbred strains of mice to induce demyelination. Those viral models, as well as models that involve the treatment of EAE by viral gene therapy, are reviewed in chapter 5. Viruses have long been implicated in the pathogenesis of MS, but the evidence is equivocal. Chapter 6 summarizes the evidence linking the various candidate viruses to the pathogenesis of MS. The book finishes strongly with the final chapter highlighting the unknown and controversial areas that need to be demystified by future research.