Abstract
Central nervous system (CNS) inflammation has been considered to be the main pathological feature of multiple sclerosis (MS). However, the complexity of this autoimmune disorder also comprises neurodegenerative processes that may occur within acute phases of inflammation, yet also temporally independent and outside of inflammatory lesions or even in so-called normal appearing white matter. Measurement strategies for neurodegeneration and neuroprotection include clinical parameters, magnetic resonance imaging and novel instruments such as diffusion tensor imaging or optical coherence tomography. Neurotrophic factors activate endogenous neuroprotective pathways. Their up-regulation by CNS-infiltrating immune cells has led to the concept of neuroprotective autoimmunity. The capacity to enhance this endogenous neuroprotection is a valuable property for therapeutic agents and has in detail been studied for glatirameracetate, laquinimod and dimethylfumarate. Multimodal measurement of neuroprotective properties of established and novel MS therapeutics and further elucidation of neuroprotective pathways within the autoimmune process will be useful to augment our insight into the complexity of the disease and to improve therapy, especially in terms of long-term disability and cognitive decline.
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Acknowledgments
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. A. Stroet has received personal compensation for activities with Novartis, Sanofi and Almirall Hermal GmbH. R. A. Linker has received personal compensation for activities with Bayer Healthcare, Biogen Idec, Fresenius, Genzyme, Merck Serono, Novartis, Terumo BCT and Teva Neuroscience, patent payments from Biogen Idec and research support from to-BBB, Biogen Idec, Merck Serono, Novartis and Teva Neuroscience. R. Gold has received personal compensation for activities with Bayer Healthcare, Biogen Idec and Teva Neuroscience and in an editorial capacity from Therapeutic Advances in Neurological Disorders, and also received patent payments from Biogen Idec and research support from Bayer Healthcare, Biogen Idec, Merck Serono, Teva Neuroscience, Novartis and from the German Ministry for Education and Research (BMBF, “German Competence Network Multiple Sclerosis” (KKNMS), CONTROL MS, 01GI0914).
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Stroet, A., Linker, R.A. & Gold, R. Advancing therapeutic options in multiple sclerosis with neuroprotective properties. J Neural Transm 120 (Suppl 1), 49–53 (2013). https://doi.org/10.1007/s00702-013-1037-6
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DOI: https://doi.org/10.1007/s00702-013-1037-6