Multiple sclerosis (MS) disease, a progressive disorder of the white matter 
  of the central nervous system, continuous to challenge investigators trying 
  to understand the pathogenesis of the disease and to prevent its progression. 
  MS is generally believed to be an immune mediated disorder that occurs in genetically 
  susceptible people. Although the sequence of event that initiates the disease 
  remains largely unknown. MS typically begins in early adulthood and has variable 
  prognosis. Fifty per cent of patients will need help walking within fifteen 
  year after the onset of disease. The prevalence of MS varies considerable around 
  the world. Kurtzke classified regions of the world according to prevalence: 
  a low prevalence was considered less than 5 cases per 100.000 persons an intermediate 
  prevalence was 5 to 30 per 100.000 persons and a high prevalence was more than 
  30 per 100.000 persons. The prevalence is highest in North Europe, Shoutern 
  Australia and the middle part of North America. There has been a trend towards 
  an increasing prevalence and incidence in Southern Europe. The reasons for the 
  variation in the prevalence and the incidence of MS worldwide are not understood. 
  Environmental and genetically explanation have been offered and both factors 
  probably have a role. Studies that show that the incidence of MS among the adopted 
  children of patient with MS is not higher than expected seem to argue against 
  the possibility that a transmissible factor is primarily responsible for the 
  increased risk of the disease among relatives and instead suggest that genetic 
  factors may be responsible. The disease typically manifests between the ages 
  of 20 and 40 and affects women twice as often as man. MS is generally categorised 
  has been either relapsing-remitting (RR) or primary-progressive (PP) in onset. 
  The RR form of disease is characterised by series of attacks that risolves in 
  varying degrees of disability from which the patient recover partly or completely 
  usually followed by remission period of variable duration before another attack. 
  The PP forms lack that acute attacks and instead typically involved a gradual 
  clinical decline. 
The primary goal of this WP is focused to generate T cells, both ab and gd TCR+, obtained from the blood of MS patients and from healthy individuals, specific for lipid antigens isolated from human myelin. We will generate appropriate antigen presenting cells expressing CD1 molecules to enable presentation of lipid antigens. We will establish lipid-specific primary T cell lines during the first 6 months of the project, and from those T cell clones will be generated and used for further studies in collaboration with the other Units. In addition we will perform immunophenotyping of the cells present in the CSF of MS patients. The complexity of the immune system is such that identification of phenotypically (and functionally) homogeneous subsets requires the simultaneous measurement of several cell surface antigens. Unless subsets are uniquely identified by appropriate multiple markers, comparative functional studies between individuals will be artefactually affected by a differential (and unknown) representation of unresolved, functionally distinct subsets. Furthermore, we will establish cells lines and clones from cells present in the CSF in order to study their functional attributes. Subsets of interest will be sorted and expanded according to standard procedures. All lines and clones will then be tested for their reactivity towards relevant CNS antigens. Antigen responsiveness will be evaluated by proliferation assays and by measurement of cytokines produced following antigen-specific challenge.
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