At 42 years old, Stephanie Goldstein developed occasional blurred and double vision,
numbness and “pins and needles” in her arms and legs (paresthesia), and bladder
incontinence. After a month of these symptoms she went to her doctor, who sent her to the
neurology specialist. An MRI scan revealed areas of demyelination in the central nervous
system (CNS), and Stephanie was diagnosed with the autoimmune disease multiple
sclerosis (MS). Which of the following best explains why some people are susceptible to
the development of MS?
a.Negative selection of autoreactive T cells occurs during T-cell development.
b.Apoptosis of autoreactive B cells occurs in the bone marrow during B-cell development.
c.An inability to produce immunological tolerance toward CNS-derived constituents
results in the generation of self-reactive lymphocytes.
d.An immunodeficiency inhibiting somatic recombination of immunoglobulins and T-cell
receptors results in impaired lymphocyte development.
e.Regulatory T cells fail to activate autoreactive T cells in secondary lymphoid organs.