Myelitis especially idiopathic and immune mediated myelitis

In the field of neurology, understanding the mechanisms of myelitis, particularly idiopathic and immune-mediated types, is crucial.Multiple sclerosis (MS) is a condition that can affect both the brain and spinal cord, yet approximately 20% of patients do not present with lesions in the spinal cord. Conversely, why do some patients have spinal cord predominant MS?Why do some cases of NMOSD present with area postrema, brainstem, or cerebral syndromes, while others present with longitudinally extensive cord lesions?This raises key questions about the factors that direct inflammation preferentially to the spinal cord instead of the brain.The mechanisms promoting inflammation in the spinal cord versus inflammation in the brain may be different. In the case of idiopathic transverse myelitis, immune activation in the periphery, most commonly by infection or vaccination, may lead to a cascade of inflammation in a genetically susceptible person. Immune cells home to the spinal cord, directed by adhesion molecules and chemokine receptors, with disruption of the blood-brain-barrier, and immune mediated injury. There may be regional expression of autoantigens within the cord which become the target of an immune response.A number of factors appear to play a role in susceptibility to CNS inflammation in the case of multiple sclerosis including genetics, vitamin D, smoking, and obesity. Perhaps some of these factors may be involved in susceptibility to idiopathic transverse myelitis as well.Despite recent advances, the causes of idiopathic transverse myelitis remain largely enigmatic, as does the optimal treatment approach. Additionally, emerging conditions like post-COVID myelitis and acute flaccid myelitis (AFM) demand attention due to their impact on the spinal cord with consequent disability and to the complexity of their inflammatory profiles.This Research Topic aims to address the underlying mechanisms that determine the site-specific manifestation of inflammation in myelitis. Key questions include why MS affects the spinal cord in some individuals but not others, and what directs inflammation to one location over the other.Furthermore, it seeks to explore the causes of idiopathic transverse myelitis and develop better treatment strategies. Special attention will also be given to post-COVID myelitis and acute flaccid myelitis in the context of spinal cord inflammation.To gather further insights into this domain, we welcome articles addressing, but not limited to, the following themes:• Mechanisms directing MS lesions to the spinal cord versus the brain• Causes and treatment advances for idiopathic transverse myelitis• Inflammatory processes in post-COVID myelitis• Pathophysiology of acute flaccid myelitis and its impact on the spinal cord• Comparison of spinal cord and brain inflammation pathwaysTopic Editor is Christopher Bruce Lock is employed by Amgen - Speakers Bureau. The other Topic Editors declare no competing interests with regard to the Research Topic subject. Topic editors: Christopher Lock, Keith Van Haren Source: https://www.frontiersin.org/research-topics/75463/myelitis-especially-idiopathic-and-immune-mediated-myelitis