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While there is now little doubt that a degenerative process operates not only in the later progressive phase of the disease, but also likely from the earliest stages of relapsing inflammatory presentations, what is fiercely debated is whether a primary autoimmune inflammation also drives the continuing CNS cytodegeneration and CNS atrophy (Sen et al., 2020

Typically, conventional treatment involves the administration of high-dose vitamin B12 injections

Kutscheidt, K., Dresler, T., Hudak, J

Furthermore, MSTN shares with TGF-1 a positive feedback loop, with TGF-1 enhancing MSTN expression, and, conversely, MSTN inducing TGF-1 secretion [59]

Complementary mechanisms without receptor competition

Maintaining a balanced lifestyle involves hydration, nutrition, and consistent habits