Immunosuppressive therapy for multiple sclerosis

The rationale for treating multiple sclerosis (MS) with immunosuppressive therapy rests on the hypothesis that MS is an inflammatory, cell-mediated, autoimmune disease, affecting the central nervous system. Elevation of interferon-gamma, endothelial-cell activation with expression of class 11 and adhesion molecules, and macrophage-mediated destruction of myelin via receptor-mediated endocytosis provide evidence that MS is an inflammatory disease. Further evidence for a Th1- or cell-mediated autoimmune process includes interleukin 2 expression and B7-1 upregulation within active lesions. Therapy with drugs that have pronounced anti-inflammatory and immunosuppressive effects has been used for the treatment of non-neoplastic diseases in which autoimmune mechanisms are considered important in the pathogenesis.