Current Status and Future Prospective of Immunointervention in Multiple Sclerosis

Abstract

Multiple sclerosis (MS) is a complex neurological disorder characterized by inflammation and degeneration of the central nervous system, primarily involving the white matter. On the basis of a wide body of evidence in experimental models and in affected patients, several attempts to treat MS using drugs which modulate immune reactions have been performed or are currently ongoing. However, it should be stressed that inflammation does not have only a detrimental effect in MS. In fact, parts of the inflammatory events are crucial for the control and conclusion of the acute phase of damage and it is probable that they actually favor regeneration and recovery. Due to the above, several trials with immunosuppressant drugs failed or were suspended because of unexpected worsening of the course of MS. The knowledge of MS immunopathogenesis is so rapidly evolving that any attempt to review it is in some way frustrating. On the other hand, this evolution is at the basis of the several new treatment options which can be hypothesized for this disease. The current status of immunosuppression in MS and the possible future development of MS treatment will be reviewed, with particular reference to those treatments which have already been tested in clinical trials and which are based on sound evidence of a putative interference with specific events occurring in MS, with the sparing of general immunity.

Cationic Liposomes Target Sites of Acute Neuroinflammation in Experimental Autoimmune Encephalomyelitis

“…The main focus of current MS therapy is on the immune response through systemic administration of drugs . Drug delivery to inflammatory sites of BBB could enable local interference in the inflammatory process, allowing administration of lower doses of drugs compared to systemic administration, and thus reduction of side effects.…”

“…The main focus of current MS therapy is on the immune response through systemic administration of drugs. 42 Drug delivery to inflammatory sites of BBB could enable local interference in the inflammatory process, allowing administration of lower doses of drugs compared to systemic administration, and thus reduction of side effects. Delivery of colloidal particles by passive infiltration across leaky BBB has already been demonstrated, 43,44 however, long circulating times are necessary to obtain sufficient uptake.…”

The secretome of periodontal ligament stem cells from MS patients protects against EAE

“…Multiple sclerosis (MS) is a crippling chronic autoimmune inflammatory disease characterized by the infiltration of immune cells to the central nervous system (CNS), demyelination and axonal loss, which produce the development of neurological symptoms1. Reports say that MS affects more than 2.5 million people among the general population.…”

Therapeutic Administration of Mesenchymal Stem Cells Abrogates the Relapse Phase in Chronic Relapsing-Remitting EAE

“…Multiple Sclerosis (MS) is a crippling chronic disease of the Central Nervous System (CNS) caused by an autoimmune reaction which progressively damages the axonal myelin sheath, both directly and through the creation of an inflammatory environment, thus leaving the axons exposed to possible damage [1]. This condition causes impairment of axonal transmission and leads to the development of neurological symptoms.…”

“…Autoimmunity and inflammation is the sparks which kindle the fire and trigger the demyelination that progressively affects nervous transmission up to complete fiber degeneration. Moreover, immune cells also give rise to a pro-inflammatory milieu which further worsens nerve fiber structure and functionality and, for these reasons, both inflammation and demyelination are the hallmarks of MS [1].…”