Good points Paul, although I think it's pretty much solid fact that MS is an autoimmune disease, at least in the RRMS phase.
Do you really think so?
Read that paper by Barnett & Prineas. (http://www.CPn Help.org/files/Ref1_Annals04.pdf
). These two are renowned neurologists not alternative practioners or snake-oil salesmen. In essence, what they found was that oligodendrocytes start dying before any immune system cells show up. The first immune cells to show up were macrophages and only later T- and B-cells. While it's clearly the case that inflammation is very often associated with relapses, perhaps it's a mistake to see it as causal. This position is further supported by
1. Computer-assisted MRI scans showing that some of the tissue damage, even in RRMS, is not associated with inflammation.
2. As you allude to: inflammation is virtually completely absent from progressive forms of the disease.
3. Campath studies showed damage continuing after all the T-cells were destroyed, so if nothing else, the disease cannot be T-cell mediated autoimmunity.
4. The very poor performance of interferon beta at delaying onset of secondary progressive and long-term disability.
5. The inability to find an antigen to which autoimmunity can be directed - this different to classical autoimmune diseases such as rheumatoid athritis or systemic lupus.
In support of your position is the fact that interferon betas and Tysabri do appear to effect the incidence of relapses. Then again it might be the case that while the inflammation does cause the symptoms, the inflammation of itself might be caused by a third factor such as the oligodendrocyte cell death as observed by Barnett & Prineas.
Personally, I think autoimmune explanations of multiple sclerosis are in serious trouble but they suit far too many interests to be abandoned. It seems counter-intuitive that the disease changes its mechanism at the point of change from RR to SP. The autoimmune school have to explain all this contrary data - something they haven't managed to do to my satisfaction. If were going to follow proper scientific method, we should abandon the autoimmune theory.