ACTUALITY
From MUSIC study commissioned by AISM (Medical Time n° 653, 2000:12) it comes out that:

• in the period 1996/1997, that means before the very expensive use of Interferon caught on, in Italy about 2000-2500 billions Italian lire were spent for Multiple Sclerosis.
• In Italy the number of people affected by MS (they were already 50.000 at the end of 1997) increases at the rate of 1800 new cases each year:
• A patient with slight disability costs 29 millions It. Lire/year;
• A patient in a wheelchair costs about 75 millions It. Lire/year. To these amounts we must add the "so-called intangible costs, that is the costs related to life quality and to the psychological consequences of this disease".

1. "In animal samples, viruses are always primarily involved in the generation of the myelic damage, a fact that has never been demonstrated for an infective agent in MS" (page 200).
2. "From the excursus on the virologic research on MS it emerges that nobody has identified a viral agent responsible for the etiology of this disease yet." (page 265).
3. From immuno-pathologic studies it emerges that "it does not seem to exist, then, a demyelinizing specificity at systemic level which could explain why those cells will go right to the CNS of all places, to damage the local parenchyme" (page 230).
4. MS is defined "an autoimmune disease". " However, contrary to other diseases such as myasthemia gravis and rheumatoid arthritis, the postulate of autoimmunity has never been demonstrated for MS by, for instance, studies of passive and active translation" (page 208).
5. Pharmacological treatment with single substances: "First of all, the effectiveness of these treatments has been demonstrated only for some kinds of courses; in a second place, the frequency of the attacks is on average reduced to about one/third and the accumulation of handicap is only incidentally affected; finally, the response to therapies has resulted rather changeable from patient to patient". The response of a certain patient is not foreseeable (page 342).
6. Combined pharmacological treatments: "Both Inf-B and Cop-1 have a partial effectiveness in controlling the disease activity and, moreover, it seems that the effect on relapses is only partially successful in the reduction of handicap progression: most patients continue to have new lesions and new attacks, even if with a significantly reduced frequency" (page 357).
7. In the introduction, Rita Levi Montalcini concludes by saying that: "both the most common forms and the progressive and secondary forms of MS up to now cannot be treated".

PERSPECTIVES
From MS pathologic Anatomy, from Microbiology, Molecular Biology and Immunology, we know that:

1. the endocerebral deposits of immune complexes are eluable (they may be easily removed by pouring some water on them), therefore they are not constituted of autoantibodies fixed at the cerebral tissue;
2. the pertussis toxins (endotoxins) are not neutralized by specific antibodies, they have a strong tropism for neuroepitheliums; the toxin of fimbriae (Filamentous Hemoagglutinin, or FHA) has, at its free extremity, the "adhesins"("chains" of anchor to the "adhesive molecules" expressed by the vasal endothelium);
3. the specific pathogenic action of pertussis Toxin (PT) consists in inducing into immunocompetent and neuroepithelic cells: inhibition of inhibiting Gi protein, inhibition of adenylatecyclase, activation of phospholipase, activation of ionic channels, modified trasduction of membrane signals;
4. pertussis toxins have a very powerful action activating aspecific policlonal both on B-lymphocytes and T-lymphocytes and on macrophages; besides, they activate the two-directional reaction T-lymphocytes/macrophages, with release of Interleukine and Interferon.

1. in 72 patients with definite MS, not selected according to their clinic form and treatment, the research of total anti-B. Pertussis IgG and IgM has resulted positive in the 80,55% of the cases;
2. in 40 patients with definite chronic-evolutive MS, searching for antibodies of the acute phase of the infection (anti-HAF and anti-PT  IgA and IgG) by Public Laboratories (Civil Hospitals in Como and Pesaro), 36 patients (that is the 90%) resulted affected by a taking place or very recent pertussis infection;
3. in 92 patients, not selected according to their clinic form or therapeutic treatment, by searching for both the antibodies of the acute phase of the pertussis infection (anti-FHA and anti-PT IgA ) and the total anti-BB IgG and IgM, an infection from BB has been demonstrated in the 94,57% of the cases.

1. It is possible to do the specific serologic diagnosis of MS since the first attack. Categorical is the necessity of searching for the antipertussis antibodies with the correct methods: in E.L.I.S.A., indicating the optic density of the sample and the cut-off; searching for both total IgG and IgM and anti-FHA and anti-PT IgA and IgG.
2. Serodiagnosis + RM make the lumbar injection superfluous (we can spare an invasive trauma to patients). As a matter of fact, the oligoclonal bands (OB) are in many other pathologies (neurosyphilis, encephalitis, neuroborreliosis , and different others); we have false negatives if IgG only are searched for, when in intrathecal site IgA are produced (a case I have recently observed); the methods used at present do not give any indication of the specificity to which the OB address themselves.
3. To the traditional therapy against attacks (cortisone) a specific antibiotic treatment (erythromycin) must be associated.
4. For the reclaiming of the mucosae of the high respiratory tract (there is often an asymptomatic chronic rhino-sinusitis) and for  the prophylaxes of relapses,  a protocol equal to the one adopted (all over the world for years) for the long-time prophylaxes of the rheumatic disease must be executed: to administer the antibiotic for at least 5 years after the latest attack (according to some Authors, the antibiotic prophylaxes should continue for indefinite time, just as Milan School proposes for Interferon).

• the onset of handicap in the new cases is prevented;
• the evolution of the disease and the progression of disability in subjects already affected are stopped (it is not possible to treat lesions already settled, but as time goes by one has always a certain functional recovery); the antibiotic treatment is oral, at home; it may be associated to almost all medicines in the market nowadays, it is well tolerated (erythromycin can be administered to pregnant women); it has practically no side effects;
• hospital costs are reduced;
• medicine costs are reduced (Interferon and Colipomero are very expensive);
• welfare costs are reduced. The kit necessary for my serodiagnosis costs less than 50.000 It. lire; the subsequent specific therapy (home treatment, oral assumption, compatibility with any other pharmacological treatment necessary for each single case) costs about 300.000 It.lire/month for each patient (3.600.000 It.lire/year);
• finally, and above all, the greatest benefit will be at human and social level: there will be no more disables for a toxi-infective disease which can be easily treated, which can be defeated.