IJNN :: IJNN Volume 2 :: Volume 2 - Issue 2 - February 2006 :: Volume 2 - Issue 2 - Reviews :: Vol 2 - Iss 2 - Review - Multiple sclerosis: Why do we understand so little and are unable to provide meaningful therapy?


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IJNN :: IJNN Volume 2 :: Volume 2 - Issue 2 - February 2006 :: Volume 2 - Issue 2 - Reviews :: Vol 2 - Iss 2 - Review - Multiple sclerosis: Why do we understand so little and are unable to provide meaningful therapy?

Vol 2 - Iss 2 - Review - Multiple sclerosis: Why do we understand so little and are unable to provide meaningful therapy? #16252

Multiple sclerosis: Why do we understand so little and are unable to provide meaningful therapy?

Israel Steiner1, Puiu Nisipeanu2 and Itzhak Wirguin3

Departments of Neurology, 1Hadassah University Hospital, Jerusalem, 2Hillel Yaffe Medical Center, Hadera, and 3Soroka Medical Center, Ben Gurion University, Beer Sheva , Israel

Received 16 March 2005; accepted in final form 20 November 2005

Correspondence and requests for reprints should be addressed to:
Prof. Israel Steiner
Department of Neurology
Hadassah University Hospital
P.O. Box 12000
Jerusalem 91120
Israel
Tel: 972-2-6776952
Fax: 972-2-
E-mail: iSteiner@md2.huji.ac.il

Abstract
Objectives: Despite many years of intensive research, multiple sclerosis (MS) still evades understanding and its treatment remains suboptimal. Our aim in this report is to analyze the reasons for this situation, review the present available therapies and put forward several constructive suggestions.
Methodology. We searched the literature from 1966 to 2005 for relevant articles and chapters. Review articles were also included.
Results: Reasons for the current satelment in the field are the meaninglessly broad spectrum of diagnostic criteria, the inability to define the efficacy of therapies, lack of fulfillment of criteria for an autoimmune condition and the pressure from the biomedical industry.
Conclusions: Clinical criteria for diagnosis should be redefined and the new set of disease classification should be based on disease course; clinical studies should consist of homogenous group of patients and a uniform set of end points to evaluate clinical therapeutic trials should be agreed upon. Most important, a moratorium on the autoimmunity hypothesis in MS will enable to redirect funds for research with lower emphasis on autoimmunity, but rather on novel approaches to the problem.

Key Words

Nervous system, Multiple sclerosis, autoimmunity, experimental allergic encephalomyelitis

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