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Remyelination

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system with presumed autoimmune etiology. Within the last years an important success has been achieved in understanding the pathophysiology of the disease and in making available effective therapeutic agents able to change the natural course of the disorder, particularly of its relapsing-remitting form. More recently, the advances made in understanding the biology of remyelination in MS opened a wide window of opportunity to design innovative therapeutic strategies that could really have an impact in reducing progressive accumulation of disability in MS and actually function as neuroprotectors and neurorregenerators. Although difficult, this goal seems to be getting closer and new therapeutic agents are being developed to fill this gap in MS care, accompanying an increasingly deep understanding of the biology of remyelination. basic aspects related to the mechanisms of remyelination as known so far, highlighting some molecules or signals that (at least theoretically) may have an important role to justify the design of new drugs that, depending on the context, could enhance or silence their effect (cellular therapy was considered outside the scope of this review). Replenishment of oligodendrocytes, renovation of the previously damaged myelin sheath and restoration of a normal glial environment should not only be useful as a reparative remyelination therapy, restoring saltatory conduction in axons, but should represent a major boost to axon survival and a powerful protective intervention.
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Last date updated on October, 2020

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