Table 2.

Autoimmunity and multiple sclerosis (MS)

Evidence used to support the concept of autoimmunity in MS	Comments
Predominance of women affected, as in rheumatoid arthritis and systemic lupus erythematosus	Predominance of women also seen in non-autoimmune disorders such as migraine
Association of other autoimmune diseases in affected individuals and families	Not proven in large epidemiological studies of MS
Association with HLA haplotypes	The strongest HLA links are observed with hereditary haemochromatosis and narcolepsy, metabolic and neurodegenerative diseases respectively
Antimyelin antibodies in serum	Antimyelin antibodies can be detected in neurological disorders other than MS, and some antimyelin antibodies have a reparative function
Oligoclonal bands in cerebrospinal fluid	These bands are reported in other neurological diseases such as subacute sclerosing panencephalitis and neurosyphilis, conditions that are not autoimmune. Oligoclonal-band-negative cases of MS have been reported
Specific T-cell response identified during MS relapses	No T-cell response is unique or specific in MS
Partial therapeutic response of relapses to beta-interferons, glatiramer and other immunotherapies	Relapse prevention in MS may not translate into disability prevention. No immunotherapy has reduced long-term disability in MS