PubMed · 14948775
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J CERNACEK. 1952-05-20. [Viral encephalitis].. https://pubmed.ncbi.nlm.nih.gov/14948775/
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The pathogenesis and development of lesions in multiple sclerosis (MS) are still unexplained and are the subject of some controversy. On the basis of histopathological analysis of a small set of MS cases, a recently published study postulates primary oligodendroglial damage as the initiator of MS lesions, with infiltration of leukocytes into the central nervous system (CNS) as a secondary phenomenon. In this paper we outline the current controversial discussion and different concepts of lesion development in MS. We conclude that demyelination can result from different pathogenic mechanisms, with either primary autoimmune inflammation or primary oligodendroglial damage and a secondary inflammatory reaction. Lesions can be divided into four subtypes (patterns I-IV) on the basis of histopathological characteristics, which supports the idea that MS lesions develop in different ways. These new aspects may have major implications for treatment. However, except in a few specific forms, most MS patients cannot currently be assigned to one of these lesion subtypes by means of clinical and paraclinical parameters. Without this, individual treatments tailored to the pathogenesis will not be possible.
Large scale expression profiling studies provide a wealth of data that even after stratification by sophisticated biostatistical procedures leave the researcher more or less puzzled and helpless. This report is meant to encourage molecular biologists facing compounding gene lists resulting from expression profiling studies to understand them as intellectual challenges that require the researchers' solid scientific experience plus a good deal of curiosity. Three examples from expression profiling investigations on distinct aspects of brain inflammation are covered here. They show that even without good software programs it is possible to come up with reasonable biological hypotheses to be evaluated in subsequent more detailed experiments.