It seems that the perivascular space is where all begins. This would explain the relationship between MS and vascular problems.
Tissue-resident memory T cells invade the brain parenchyma in multiple sclerosis white matter lesions
https://academic.oup.com/brain/article/ ... 14/5836675
Abstract
Multiple sclerosis is a chronic inflammatory, demyelinating disease, although it has been suggested that in the progressive late phase, inflammatory lesion activity declines.
[...]
These data show that in chronic progressive multiple sclerosis cases, inflammatory lesion activity and demyelinated lesion load is associated with an increased number of T cells clustering in the perivascular space. Inflammatory active multiple sclerosis lesions are populated by CD8+ tissue-resident memory T cells, which show signs of reactivation and infiltration of the brain parenchyma.
Conclusion
Altogether, our findings point to the PVS as a new frontier for progressive multiple sclerosis treatment development. Understanding the mechanisms that are involved in CD8+ TRM cells expanding in the PVS, entering mixed active/inactive lesions, and driving ongoing inflammatory lesion activity could provide targets for new disease-modifying therapies with efficacy in progressive multiple sclerosis
The perivascular space (PVS): New frontier in MS research
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