In contrast to many diseases that affect a single part of the human body, MS affects two different body systems: the immune system and the nervous system. The immune system is not a distinct organ like the brain or liver. Instead, it is composed of many different types of molecules and cells (known as white blood cells) that travel through the bloodstream. The immune cells use chemical messages to protect the body from attack by bacteria, viruses, and cancers. MS is believed to be an autoimmune condition in which the immune system is excessively active and actually attacks the nervous system.
The central nervous system (CNS) is the part of the nervous system involved in MS. The CNS includes the brain and spinal cord. The nerves in the CNS communicate with each other through long, wire-like processes that have a central fiber (axon) surrounded by an insulating material (myelin). In MS, the immune system cells produce inflammation that injures the myelin. In addition, damage occurs to the axon. This damage is known as degeneration, which is the process that occurs in aging-related neurologic diseases such as Alzheimer's and Parkinson's disease. The injury to the myelin and axons results in a slowing or blocking of nerve impulses that prevents the affected parts of the nervous system from functioning normally.
The cause of MS is not entirely clear. It is believed that two important factors are involved in developing the disease, one of which is environmental and the other genetic. The characteristic geographic distribution of MS indicates that an environmental factor is present. One hypothesis is that individuals are exposed to a particular virus during childhood. This viral infection may be more common in cooler climates that are more distant from the equator. Another theory relates the geographic distribution to vitamin D, which mildly suppresses the immune system and thus could be protective against MS. Because vitamin D becomes active with sunlight exposure, those who live farther from the equator (with less-direct sunlight exposure) may have lower levels of vitamin D levels and higher risks of developing MS.
The presence of a genetic factor is suggested by family studies that demonstrate a hereditary predisposition to MS. Some genetic diseases are "dominant" and are clearly passed down through generations. MS usually is not passed on in such a well-defined pattern. Rather, there may exist an inherited predisposition to the disease that must be present in addition to an environmental agent to cause disease. Ongoing, intensive research efforts are aimed at identifying specific genes that increase the risk of developing MS or affect the severity of the disease.
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