By studying gene transcripts in active lesions of multiple sclerosis via robotic sequencing and gene chips, as well as studying the very same tissue via proteomics, we have discovered several targets at the tipping points in pathophysiologic pathways controlling relapse and remission in multiple sclerosis. In this Charcot Lecture, I shall focus on osteopontin-the binding partner for alpha4 beta 1 integrin, on alpha B crystallin and on two members of the coagulation cascade tissue factor and the inhibitor of protein C. These four proteins are critical in controlling relapse and remission in MS.