» Articles » PMID: 35674071

Progression in Multiple Sclerosis - a Long-term Problem

Overview
Specialty Neurology
Date 2022 Jun 8
PMID 35674071
Authors
Affiliations
Soon will be listed here.
Abstract

Purpose Of Review: Disability progression in multiple sclerosis (MS) is strongly linked to central nervous system (CNS)-specific pathological processes that occur throughout all disease stages, but that become clinically evident in later phases of the disease. We here discuss current views and concepts for targeting progressive MS.

Recent Findings: Detailed clinical assessment of MS patients has identified an even closer entanglement of relapse-remitting and progressive disease, leading to novel concepts such as 'progression independent of relapse activity'. Evolving clinical concepts together with a focus on molecular (neurofilament light chain) and imaging (paramagnetic rim lesions) biomarkers might specifically identify patients at risk of developing progressive MS considerably earlier than before. A multitude of novel treatment approaches focus either on direct neuroaxonal protection or myelin regeneration or on beneficially modulating CNS-intrinsic or innate immune inflammation. Although some long-awaited trials have recently been unsuccessful, important lessons could still be drawn from novel trial designs providing frameworks for future clinical studies.

Summary: Targeting progressive disease biology and repairing established damage is the current central challenge in the field of MS. Especially, the compartmentalized adaptive and innate CNS inflammation is an attractive target for novel approaches, probably as a combinatory approach together with neuroprotective or myelin regenerating strategies.

Citing Articles

Increased Disability Progression in rs10191329 Carriers with Multiple Sclerosis Is Preceded by Neurofilament Light Chain Elevations.

Protopapa M, Steffen F, Schraad M, Ruck T, Ozturk M, Hanuscheck N Ann Neurol. 2024; 97(3):596-605.

PMID: 39588882 PMC: 11831884. DOI: 10.1002/ana.27144.


Exploring miRNAs' Based Modeling Approach for Predicting PIRA in Multiple Sclerosis: A Comprehensive Analysis.

Gosetti di Sturmeck T, Malimpensa L, Ferrazzano G, Belvisi D, Leodori G, Lembo F Int J Mol Sci. 2024; 25(12).

PMID: 38928049 PMC: 11203572. DOI: 10.3390/ijms25126342.


Ferroptosis induces detrimental effects in chronic EAE and its implications for progressive MS.

Jhelum P, Zandee S, Ryan F, Zarruk J, Michalke B, Venkataramani V Acta Neuropathol Commun. 2023; 11(1):121.

PMID: 37491291 PMC: 10369714. DOI: 10.1186/s40478-023-01617-7.


Implications of immunometabolism for smouldering MS pathology and therapy.

Bittner S, Pape K, Klotz L, Zipp F Nat Rev Neurol. 2023; 19(8):477-488.

PMID: 37430070 DOI: 10.1038/s41582-023-00839-6.