I don't think many believe literally in the auto-immune theory. As I have said before, one of my neuros said that 'everything is autoimmune until the virus or bacteria is identified'. They haven't identified it yet - but not for want of trying.
The researchers know that inflammation plays a part - but whether this is the primary or secondary event has still to be worked out. Will aggressive suppression of inflammation early in the disease limit damage and delay / stop the progressive phase? Trials such as Campath will provide an answer.
The researchers know that MS is as much a neuro-degenerative disease as an inflammatory disease. More and more research is focused on how to stop the neuro-degeneration and also to repair the damage.
There is much work going on behind the scenes and more is known about what damage is being done and the possible mechanisms driving this damage.
What do we know now that we didn't know 10 years ago? We know that MS is much more than a disease of myelin, damage to the nerve fibre takes place and leads to disability. We know that in addition to the white matter (myelin), the grey matter is also damaged. We know that damage is more than just focal (lesions) and is widespread throughout the CNS. We know that the interferons have some impact on the number of relapses, but have little impact on disability and disease progression. We know that it is possible to dramatically reduce relapses and inflammation (Campath, Mitoxantrone, Tysabri). We know more about some of the inflammatory mechanisms (eg how immune cells cross the Blood Brain Barrier). We know that B cells play a role - not just T cells. We know that some re-myelination takes place. We know that testosterone, statins and minocycline are likely to provide benefits. We know on which chromosome the 'MS' genes are on.
So we do know more, much more. And with this knowledge, better treatments are in trial.
Neuro-protrective treatments and repair treatments are in early stages of testing, but this is another step forward.
Breakthroughs are coming - this assessment is not just based on hope but an appreciation of the advances being made.
For those who have had this disease for years (sometimes decades), these future advances will not be able to give back the years lost. There have been many false dawns and the sceptics have good cause to be sceptical. But it is not unreasonable to imagine that within 5 years or so, the medical profession could stop relapses and inflammation (they can do this now - although the drugs bring some risks), that there will be treatments to protect the nervous system (from degenerating), and that treatments to encourage repair will be in late trials.
So by September 2011, this site should be shut down. Arron will get himself a real job, Anecdote can concentrate fulltime on her painting, Jimmylegs and Dignan will be married with kids, and HarryZ will be writing to the FDA everyday demanding that Tysabri be withdrawn.
I attach some recent research that shows how the understanding of MS is increasing and how the strategies to address the disease are reflecting this new understanding.