Multiple sclerosis (MS) is an inflammatory-mediated demyelinating disease of the human central nervous system. The clinical disease course is variable, usually starts with reversible episodes of neurological disability in the third or fourth decade of life, and transforms into a disease of continuous and irreversible neurological decline by the sixth or seventh decade. We review data that support neurodegeneration as the major cause of irreversible neurological disability in MS patients. We question whether inflammatory demyelination is primary or secondary in the disease process and discuss the challenges of elucidating the cause of MS and developing therapies that will delay or prevent the irreversible and progressive neurological decline that most MS patients endure.

中文翻译：

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多发性硬化症：是免疫性疾病还是神经退行性疾病？

多发性硬化症（MS）是人类中枢神经系统的炎症介导的脱髓鞘疾病。临床疾病的过程是可变的，通常始于生命的第三或第四十年中可逆的神经功能障碍发作，并在第六或第七十年中转变为持续且不可逆的神经功能下降的疾病。我们审查了支持神经变性为MS患者不可逆神经系统残疾的主要原因的数据。我们质疑炎症性脱髓鞘在疾病过程中是原发性还是继发性，并讨论了阐明多发性硬化症的病因和开发可延缓或预防大多数多发性硬化症患者所忍受的不可逆和进行性神经衰弱的疗法的挑战。