Brain Sci. 2013, 3(3), 1282-1324; doi:10.3390/brainsci3031282

Myelin Recovery in Multiple Sclerosis: The Challenge of Remyelination

1,2,3email, 2email, 3email and 1,2,4,* email
Received: 8 July 2013; in revised form: 12 August 2013 / Accepted: 12 August 2013 / Published: 28 August 2013
(This article belongs to the Special Issue Myelin Repair)
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Abstract: Multiple sclerosis (MS) is the most common demyelinating and an autoimmune disease of the central nervous system characterized by immune-mediated myelin and axonal damage, and chronic axonal loss attributable to the absence of myelin sheaths. T cell subsets (Th1, Th2, Th17, CD8+, NKT, CD4+CD25+ T regulatory cells) and B cells are involved in this disorder, thus new MS therapies seek damage prevention by resetting multiple components of the immune system. The currently approved therapies are immunoregulatory and reduce the number and rate of lesion formation but are only partially effective. This review summarizes current understanding of the processes at issue: myelination, demyelination and remyelination—with emphasis upon myelin composition/ architecture and oligodendrocyte maturation and differentiation. The translational options target oligodendrocyte protection and myelin repair in animal models and assess their relevance in human. Remyelination may be enhanced by signals that promote myelin formation and repair. The crucial question of why remyelination fails is approached is several ways by examining the role in remyelination of available MS medications and avenues being actively pursued to promote remyelination including: (i) cytokine-based immune-intervention (targeting calpain inhibition), (ii) antigen-based immunomodulation (targeting glycolipid-reactive iNKT cells and sphingoid mediated inflammation) and (iii) recombinant monoclonal antibodies-induced remyelination.
Keywords: calpain; central nervous system; demyelination; fingolimod; glycolipids; lipids; multiple sclerosis; myelin; myelination; NKT cells; oligodendrocytes; remyelination; T cells
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Podbielska, M.; Banik, N.L.; Kurowska, E.; Hogan, E.L. Myelin Recovery in Multiple Sclerosis: The Challenge of Remyelination. Brain Sci. 2013, 3, 1282-1324.

AMA Style

Podbielska M, Banik NL, Kurowska E, Hogan EL. Myelin Recovery in Multiple Sclerosis: The Challenge of Remyelination. Brain Sciences. 2013; 3(3):1282-1324.

Chicago/Turabian Style

Podbielska, Maria; Banik, Naren L.; Kurowska, Ewa; Hogan, Edward L. 2013. "Myelin Recovery in Multiple Sclerosis: The Challenge of Remyelination." Brain Sci. 3, no. 3: 1282-1324.

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