Axonal degeneration in the pathogenesis of multiple sclerosis

: Axonal degeneration plays an important role in the cumulation of disability in patients with multiple sclerosis (MS). Pathological studies have demonstrated axonal damage, particularly in area of acute inflammation and demyelination, and in chronic lesions. The mechanism of axonal loss is uncertain, but may involve axonal degeneration which is secondary to demyelination. Mediators of inflammation, including cytokines and proteolytic enzymes may be responsible for axonal damage, as may be nitric oxide. Moreover, axonal destruction might be due to immune cells attack directed to axonal components. The method to evaluate the intensity of cerebral and spinal cord atrophy, both reflecting axonal damage, is still searched. It is thought that therapy affecting the axonal destruction would possibly reduce progression of disability in MS patients.