Multiple sclerosis is a chronic, autoimmune, neurological disease that affects the brain and spinal cord, and is most commonly diagnosed in young women — for every man, there are three to four women with this condition — in their 30s. In Spain, it affects 50,000 people, or, what is the same, a hundred people for every 100,000 inhabitants.
In multiple sclerosis, the immune system plays a central role. “It is a disease that destroys the multilayered structure that surrounds the nerves, which is myelin, ” summarizes Celia Oreja-Guevara, head of the Neurology Section of the San Carlos Clinical University Hospital in Madrid and President of the AEDEM-COCEMFE Medical Advisory Council . “This layer is what allows the nerve to conduct electrical conduction; the one that makes it possible that, when the brain commands a hand to move, the finger moves ”. During the development of the disease, the nerve begins to malfunction, “and then it stops,” he explains.
The causes of sclerosis are still unknown ; The only thing that is known is that some cells of the immune system, the peripheral lymphocytes, that circulate in the blood, for some reason that scientists do not know – it is believed that a virus or a bacterium has something to do with it -, cause that, while they circulate through the blood, they are activated against myelin. “There they pass to the brain, they also interact with B lymphocytes, and at that point an inflammatory cascade is produced that destroys myelin,” says Dr. Oreja-Guevara.
As for the symptoms, the first of all is the appearance of blurred or double vision , to which is added later the loss of sensitivity of some part of the body, whether in the arm, leg, or face. for more than twenty-four hours (never less). From there, the difficulty of movement comes: “The patient has problems walking, balance, urinary problems, in the bladder …”, says Dr. Oreja-Guevara.
The causes are not known, but it is already known that, without being exactly hereditary, there are certain genes that slightly increase the risk of suffering from it . Regarding environmental factors, the low levels of vitamin D and having suffered from mononucleosis or kissing disease, caused by the Epstein-Barr virus, stand out . Dr. Oreja-Guevara also highlights the change in women’s lifestyles in the last fifty years. “The hormonal factors have changed —now they take the pill—; Before they worked in the fields, with which they had vitamin D and they moved more ”. Today’s woman has a worse diet than in the past, walks less and smokes more. Smoking is a key factor, due to which the incidence has increased.
Regarding the treatments, they vary depending on each case, but corticosteroids are usually administered to reduce inflammation. In some types of disease (such as primary progressive) there is hardly any treatment available. Here, according to Dr. Oreja-Guevara, lies the great challenge of sclerosis: “We must find treatments that remyelinate, that is, that re-regenerate the myelin that has been lost … Or at least that they manufacture more neuroprotectors, that do not synthesize myelin but protect the destruction of the nerve ”, he concludes.
