Immunological Aspects Related to the Pathophysiology of Multiple Sclerosis and the Possible Checkpoints for Target Therapy: An Integrative Literature Review

Abstract

Multiple sclerosis (MS) is the most common chronic demyelinating disease of the central nervous system (CNS), with an autoimmune inflammatory mechanism, but the immunological analysis, described in the pathogenesis of the disease, is not attributed or significantly placed in the universally used criteria. In this regard, this literature review aims to highlight immunological aspects that can be attributed both to the diagnosis and treatment of MS. In this sense, this review compiled and interpreted 41 articles found published between 2010 and 2020, indexed on the platforms: PubMed, Scielo and LILACS. Of these only 6 articles contained the proposed inclusion criteria. It was possible to show that CD4 T lymphocytes are activated by antigen presenting cells (microglia and B lymphocytes), adopting Th1 profiles (producing IFN-γ and TNF-α) and Th17 (producing IL-17 and IL-22); from the activation of B lymphocytes, they are differentiated into plasmocytes that will produce IgG4; due to the action of autoreactive lymphocytes, there is an inflammation at the neuronal level that triggers demyelination. In this sense, it is concluded that there is a need to encourage more research regarding the reduction of the inflammatory response in relation to MS and also the encouragement of clinical studies that are already being followed up, given the positive results presented by them and an improvement in the quality of life of their patients.