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Multiple Sclerosis: Immunology, Pathology, and Pathophysiology

Multiple Sclerosis: Immunology, Pathology, and Pathophysiology edited by Robert M. Herndon, MD, 258 pp, with illus, $89.95, ISBN 1-888799-62-5, New York, NY, Demos Medical Publishing, Inc, 2003. One is struck when opening this book by the dedication to 3 leaders in the field of multiple sclerosis (MS) who tragically had nearly simultaneous untimely deaths in 2001: Larry Jacobs, MD ("The Jake"), John Whitaker, MD, and John Trotter, MD. The memory of these 3 outstanding individuals provides a compelling backdrop against which to tackle the important basic science issues of MS and its pathophysiologic characteristics. The book remains true to the trail blazed by these giants as it provides an overview of immunologic features, pathologic characteristics, and experimental models of MS. The editor has brought together accomplished researchers and physicians from various disciplines in the allied neuroscience community to provide a unique and authoritative review. A reading of the author affiliations shows representation from neurology, pathology, microbiology, neuroscience, immunology, and imaging. One theme that resonates clearly is the need for a multidisciplinary approach to studying this interesting and complex disease. Such collaboration forms the basis of the most successful MS research programs. The book is divided into 4 major sections. The first section describes the morphologic features and biochemistry of oligodendrocytes, myelin, and astrocytes. It includes several excellent electron micrographs and schematics. Emphasis is placed on structure and function of the key elements composing the production and support of myelin generation and repair. This forms a good foundation for the remainder of the chapters. There is a particularly informative description of myelin structure, molecular organization, and maturation not typically found elsewhere. The second section deals with experimental aspects of demyelination including immune system trafficking, animal models, tissue culture studies, and the role of pathogens such as viruses and bacteria. This includes a provocative chapter on the association of Chlamydia pneumoniae with MS. The information in this section is quite detailed yet comprehensive and presented in an organized and clear manner. I particularly like the use of diagrams to illustrate the neuroimmunologic characteristics of MS in a way that is friendly to nonimmunologists. The third section deals with cytokines, chemokines, and interferons. In this section the rubber meets the road; that is, the principles of autoimmunity and dysimmunity are translated into the framework of MS pathophysiologic features and treatment. This section starts with a well-written chapter on the role of cytokines in inflammatory demyelinating diseases. The authors have made a seamless transition from basic immunologic features to tissue effects and disease effects of cytokines and chemokines, followed by a rationale for immunotherapy. The chapters on chemokines, receptors, and interferons also show the translational research machine put into action, in which basic science meets clinical science. The fourth section deals with the pathologic characteristics of MS, including the clinical and neuropathologic spectrum of demyelinating diseases, role of magnetic resonance imaging in monitoring tissue changes, and basic mechanisms of repair and adaptation. In the chapter on pathologic features, I was pleased to see a detailed discussion of gray matter plaques, an area of increasing interest. The magnetic resonance imaging chapter is a tour de force with excellent breadth and fine illustrations. A few minor shortcomings are deserving of comment. The book would have been enhanced by more discussion of cutting-edge issues relating to the pathophysiologic features of disease, such as functional genomics and gene expression. I would have liked more discussion on putative secondary mediators of injury, including those possibly participating downstream in the cascade of immune-triggered tissue loss (eg, glutamate excitotoxins, free radicals, and growth factors). This would lead directly to perhaps the most exciting and untapped area of MS therapy: neuroprotection. Although therapy is mentioned in some detail throughout the chapters, more detailed discussion of experimental therapies and translation research expanded from the basic science framework would have been desirable (eg, stem cell therapy). A chapter or two focused on the relationship between immunologic features and the clinical expression of disease, such as a cogent summary of prognostic disease factors and the relationship between pathologic characteristics and disability, might also be helpful. However, in the preface the editor refers to this book as a companion to another book on clinical issues. Finally, a few of the illustrations were compromised owing to low resolution or poor contrast, probably related to electronic submission. In summary, as a person who approaches this area as an academic neurologist, neuroimager, and MS specialist with little background in hard-core immunology or pathology, I found this to be a valuable resource. There is surprisingly little redundancy and an excellent flow among the sections and chapters, likely a result of editorial prowess. I believe this reasonably priced book will be pleasing to a wide audience of scientists and academic physicians in the MS field. Prose⋆⋆⋆⋆ Illustrations⋆⋆⋆ Science⋆⋆⋆⋆ Usefulness⋆⋆⋆⋆ http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Multiple Sclerosis: Immunology, Pathology, and Pathophysiology

Archives of Neurology , Volume 61 (6) – Jun 1, 2004

Multiple Sclerosis: Immunology, Pathology, and Pathophysiology

Abstract

edited by Robert M. Herndon, MD, 258 pp, with illus, $89.95, ISBN 1-888799-62-5, New York, NY, Demos Medical Publishing, Inc, 2003. One is struck when opening this book by the dedication to 3 leaders in the field of multiple sclerosis (MS) who tragically had nearly simultaneous untimely deaths in 2001: Larry Jacobs, MD ("The Jake"), John Whitaker, MD, and John Trotter, MD. The memory of these 3 outstanding individuals provides a compelling backdrop against which to tackle the...
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Publisher
American Medical Association
Copyright
Copyright © 2004 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.61.6.978-b
Publisher site
See Article on Publisher Site

Abstract

edited by Robert M. Herndon, MD, 258 pp, with illus, $89.95, ISBN 1-888799-62-5, New York, NY, Demos Medical Publishing, Inc, 2003. One is struck when opening this book by the dedication to 3 leaders in the field of multiple sclerosis (MS) who tragically had nearly simultaneous untimely deaths in 2001: Larry Jacobs, MD ("The Jake"), John Whitaker, MD, and John Trotter, MD. The memory of these 3 outstanding individuals provides a compelling backdrop against which to tackle the important basic science issues of MS and its pathophysiologic characteristics. The book remains true to the trail blazed by these giants as it provides an overview of immunologic features, pathologic characteristics, and experimental models of MS. The editor has brought together accomplished researchers and physicians from various disciplines in the allied neuroscience community to provide a unique and authoritative review. A reading of the author affiliations shows representation from neurology, pathology, microbiology, neuroscience, immunology, and imaging. One theme that resonates clearly is the need for a multidisciplinary approach to studying this interesting and complex disease. Such collaboration forms the basis of the most successful MS research programs. The book is divided into 4 major sections. The first section describes the morphologic features and biochemistry of oligodendrocytes, myelin, and astrocytes. It includes several excellent electron micrographs and schematics. Emphasis is placed on structure and function of the key elements composing the production and support of myelin generation and repair. This forms a good foundation for the remainder of the chapters. There is a particularly informative description of myelin structure, molecular organization, and maturation not typically found elsewhere. The second section deals with experimental aspects of demyelination including immune system trafficking, animal models, tissue culture studies, and the role of pathogens such as viruses and bacteria. This includes a provocative chapter on the association of Chlamydia pneumoniae with MS. The information in this section is quite detailed yet comprehensive and presented in an organized and clear manner. I particularly like the use of diagrams to illustrate the neuroimmunologic characteristics of MS in a way that is friendly to nonimmunologists. The third section deals with cytokines, chemokines, and interferons. In this section the rubber meets the road; that is, the principles of autoimmunity and dysimmunity are translated into the framework of MS pathophysiologic features and treatment. This section starts with a well-written chapter on the role of cytokines in inflammatory demyelinating diseases. The authors have made a seamless transition from basic immunologic features to tissue effects and disease effects of cytokines and chemokines, followed by a rationale for immunotherapy. The chapters on chemokines, receptors, and interferons also show the translational research machine put into action, in which basic science meets clinical science. The fourth section deals with the pathologic characteristics of MS, including the clinical and neuropathologic spectrum of demyelinating diseases, role of magnetic resonance imaging in monitoring tissue changes, and basic mechanisms of repair and adaptation. In the chapter on pathologic features, I was pleased to see a detailed discussion of gray matter plaques, an area of increasing interest. The magnetic resonance imaging chapter is a tour de force with excellent breadth and fine illustrations. A few minor shortcomings are deserving of comment. The book would have been enhanced by more discussion of cutting-edge issues relating to the pathophysiologic features of disease, such as functional genomics and gene expression. I would have liked more discussion on putative secondary mediators of injury, including those possibly participating downstream in the cascade of immune-triggered tissue loss (eg, glutamate excitotoxins, free radicals, and growth factors). This would lead directly to perhaps the most exciting and untapped area of MS therapy: neuroprotection. Although therapy is mentioned in some detail throughout the chapters, more detailed discussion of experimental therapies and translation research expanded from the basic science framework would have been desirable (eg, stem cell therapy). A chapter or two focused on the relationship between immunologic features and the clinical expression of disease, such as a cogent summary of prognostic disease factors and the relationship between pathologic characteristics and disability, might also be helpful. However, in the preface the editor refers to this book as a companion to another book on clinical issues. Finally, a few of the illustrations were compromised owing to low resolution or poor contrast, probably related to electronic submission. In summary, as a person who approaches this area as an academic neurologist, neuroimager, and MS specialist with little background in hard-core immunology or pathology, I found this to be a valuable resource. There is surprisingly little redundancy and an excellent flow among the sections and chapters, likely a result of editorial prowess. I believe this reasonably priced book will be pleasing to a wide audience of scientists and academic physicians in the MS field. Prose⋆⋆⋆⋆ Illustrations⋆⋆⋆ Science⋆⋆⋆⋆ Usefulness⋆⋆⋆⋆

Journal

Archives of NeurologyAmerican Medical Association

Published: Jun 1, 2004

There are no references for this article.