Despite the passage of years and the progress of science, it is still unknown what causes multiple sclerosis. And since the cause of the disease is unknown, there is also no effective cure for a complete cure. Medicine only knows how to slow the progression of the disease in some patients.
Multiple sclerosis is the most common neurological disease in young adults. According to various estimates, from 40 to 60 thousand people suffer from it in Poland. people. There are approximately 2,5 million people in the world affected by MS (sclerosis multiplex).
Multiple sclerosis belongs to autoimmune diseases, more precisely: from autoimmune disease. This means that the immune system becomes hyperactive for as yet unknown reasons. The cells of the immune system, instead of destroying only pathogens, e.g. viruses, bacteria also attack the body’s own tissues. In multiple sclerosis, cells of the immune system (such as T lymphocytes) in the blood cross the blood-brain barrier and destroy the protein sheath in the nerve called myelin. Where the myelin is destroyed, inflammation first develops, followed by a scar, or induration. Since such processes and scars can arise in many places of the central nervous system (the central nervous system – CNS – consists of the brain and spinal cord), the disease was called multiple sclerosis (Latin sclerosis multiplex).
In a healthy nervous system, information such as limb movement is transmitted almost automatically in fractions of a second from the CNS to the muscles that direct the movement. If a scar – sclerosis appears on the road, the information is transmitted with a delay or not at all. As a result, the sick person is unable to move efficiently or at all. The CNS is in charge of many of life’s activities. The symptoms you experience with MS depend on where the myelin is damaged (demyelinated) and the scarring or scarring occurs. If the area of the brain responsible for balance is damaged, the patient has problems with maintaining it, staggers, moves “as if he were drunk”. If a scar forms along the pathway that conduct nerve impulses to the eye, the person has problems seeing. Unfortunately, the disease is unpredictable. It is impossible to determine when and where the next demyelinating changes will appear. For the same reason, it is different in each patient. There are amazing contrasts: there are patients who, after many years, still move independently, lead a normal life, but there are also those who become severely disabled after just a few years.
Although the very course of pathological processes in the nervous system is known, scientists still do not know what causes an inappropriate reaction of the immune system. They cannot answer the question: why does the immune system behave inappropriately in some people? This is presumed to be due to a number of reasons. It is known that white people are more likely to get sick, especially those living further from the equator. Poland belongs to the group of countries with high incidence, similarly to Scandinavia, Germany and Great Britain. This is presumed to be due to both the overall genetic predisposition of Caucasians and to less sun exposure and therefore also to lower levels of vitamin D (and especially vitamin D3) in the body. It is also known that children who move south before the age of 15 have a lower incidence than their peers who still live in the north. Unfortunately, moving north before the age of 15 increases the likelihood of contracting the disease.
Multiple sclerosis is not hereditary. There is a group of genes suspected of having an influence on the disease, but they may only increase the risk, not the fact that the disease will definitely appear. If a parent suffers from multiple sclerosis, the likelihood that their child will also develop the disease increases from 3-5 percent according to various data.
Some scientists believe that viruses are responsible for the inappropriate response of the immune system. The main suspect was the measles virus, later herpes. It is now also believed that the problem is caused by inadequate blood flow in the jugular veins. Research is ongoing to test this hypothesis.
Importantly, women are sick twice as often. In highly industrialized regions, this percentage is even higher: there are as many as 4 women per one man with MS. This indicates a strong relationship between the incidence and the action of female sex hormones, especially estrogens. The influence of hormones is also visible in epidemiology. Among pre-pubertal children, boys are more likely to develop the disease. Later, girls have the advantage. Women with MS often feel worse during their periods. Pregnancy, on the other hand, is a time of relative peace. The immune system reduces its over-reactivity so as not to lead to rejection of the fetus. Problems appear only after childbirth, when a specific hormonal storm occurs in the body, and at the same time caring for a baby requires a lot of effort. So at this time, a woman with MS needs the help and support of her relatives in particular.
Text: Iza Czarnecka