Stress or heat shock proteins are constitutively expressed in normal central nervous system tissues in a variety of cell types (oligodendrocytes, astrocytes, and neurons). Their function is uncertain, but they may be critical during nervous system development and may protect cells from various stresses, such as hypoxia, anoxia, and excessive excitatory stimulation.Increased amounts of stress proteins are expressed in various cells of the CNS during acute toxic-metabolic states and in more chronic degenerative diseases. Increased expression of stress proteins may constitute a sensitive marker of cell injury.

Antibodies to mycobacterial stress proteins bind to normal human myelin and to oligodendrocytes in regions of MS demyelination. Some proteins in myelin that cross react with stress proteins are not human homologues. In at least one instance, it is an endogenous myelin protein, namely CNP. Cellular immune responses to stress proteins occur with increased frequency and magnitude in persons with MS, especially those with recent onset of disease. In addition, there are populations of T cells expressing y/5 T cells in the brains and spinal fluids of persons with MS. These data support the hypothesis that an immune response to an infectious agent's stress proteins could result in a cross-reactive immune response to CNS myelin, and result in demyelination. This may be an especially important mechanism in MS cases of recent onset.

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