A comprehensive review on multiple sclerosis: It’s etiology, symptoms, epidemiology and current therapeutic approaches

Abstract

Multiple sclerosis is a chronic autoimmune, inflammatory neurological disease affecting the nervous system. It targets the myelin sheath of the axons and inflicts axonal degeneration. High susceptibility is seen in people of age group 20-40 years. The incidence rate is three times more in females compared to males. There are 4 types of multiple sclerosis, namely relapsing/remitting multiple sclerosis, secondary progressive multiple sclerosis, primary progressive multiple sclerosis, progressive relapsing multiple sclerosis with relapsing-remitting being the predominant type and makes up 85% of the cases. The pathogenesis of multiple sclerosis includes destruction of myelin sheath followed by formation of lesions and inflammation. Environmental factors and genetic variables play major role in development of the disease. Exposure to viral and bacterial agents can also lead to multiple sclerosis. Disease-modifying therapies (DMTs) are the most commonly employed management strategies for treating patients with multiple sclerosis. Conventional drugs like IFN-β-1a and glatiramer acetate are now being replaced by highly effective DMTs and autologous hematopoietic stem cell transplantation. Recently, there has been drastic developments in the management of multiple sclerosis, owing to the discovery of more tailored and individualized treatment protocols catering specifically to patient needs.