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Journal of Neurology
Published in: Journal of Neurology 1/2021

Open Access 01-01-2021 | Multiple Sclerosis | Review

Promoting remyelination in multiple sclerosis

Authors: Nick Cunniffe, Alasdair Coles

Published in: Journal of Neurology | Issue 1/2021

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Abstract

The greatest unmet need in multiple sclerosis (MS) are treatments that delay, prevent or reverse progression. One of the most tractable strategies to achieve this is to therapeutically enhance endogenous remyelination; doing so restores nerve conduction and prevents neurodegeneration. The biology of remyelination—centred on the activation, migration, proliferation and differentiation of oligodendrocyte progenitors—has been increasingly clearly defined and druggable targets have now been identified in preclinical work leading to early phase clinical trials. With some phase 2 studies reporting efficacy, the prospect of licensed remyelinating treatments in MS looks increasingly likely. However, there remain many unanswered questions and recent research has revealed a further dimension of complexity to this process that has refined our view of the barriers to remyelination in humans. In this review, we describe the process of remyelination, why this fails in MS, and the latest research that has given new insights into this process. We also discuss the translation of this research into clinical trials, highlighting the treatments that have been tested to date, and the different methods of detecting remyelination in people.
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Metadata
Title
Promoting remyelination in multiple sclerosis
Authors
Nick Cunniffe
Alasdair Coles
Publication date
01-01-2021
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 1/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-019-09421-x

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