A search for susceptibility genes in multiple sclerosis

Multiple sclerosis is a chronic inflammatory, putatively autoimmune disease characterized by multifocal demyelination in the central nervous system. Two main strategies are used to identify genes influencing the susceptibility to multiple sclerosis: (i) elucidation of the role of a candidate gene chosen on the basis of the possible function of the encoded protein in etiology and/or pathogenesis of the disease, and (ii) complete genomic screen using a panel of anonymous genetic markers for identification of the chromosome regions involved in the disease development. The complete genomic search revealed multiple loci for multiple sclerosis on thirteen chromosomes, and analysis of the candidate genes added three more chromosomes to this list. The combined data prove the polygenic nature of this complex disease. Detection of individual genes responsible for susceptibility to multiple sclerosis is complicated by the genetic heterogeneity of analyzed populations and families, which is determined both by the ethnic heterogeneity and the peculiarity of clinical forms of the disease. However, it seems highly probable that HLA and non-HLA genes of the major histocompatibility complex, as well as some unidentified genes on chromosomes 5p and 17q, are involved in the disease development. In addition to HLA, some authors have also shown that a role in the disease development is played by the genes encoding other components of the trimolecular complex involved in antigen presentation: those of the T-cell receptor and the best studied autoantigen, the myelin basic protein. The most promising for further studies of the genetic susceptibility to multiple sclerosis are approaches that combine the candidate-gene strategy with the complete genomic search as well as distinguish the genetically differentiated forms of the disease.