Luessi Felix, Kuhlmann Tanja, Zipp Frauke
Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn²), University Medical Center of the Johannes Gutenberg-University of Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
Expert Rev Neurother. 2014 Nov;14(11):1315-34. doi: 10.1586/14737175.2014.969241.
Multiple sclerosis (MS) is the most common chronic inflammatory demyelinating disorder of the CNS characterized by infiltration of immune cells and progressive damage to myelin sheaths and neurons. In recent years, the importance of the neuronal compartment in the early pathology of multiple sclerosis has become increasingly clear. Direct axonal damage within the early stages of inflammation as well as neuronal injury as a result of chronic demyelination are essential factors for the development of long-term disability in patients. Viewing MS as both inflammatory and neurodegenerative has significant implications for treatment, with remyelination of denuded axons to protect neurons from damage being necessary in addition to controlling inflammation. Here, we review recent molecular insights into key molecules and pathways controlling the differentiation of oligodendrocyte progenitor cells and the regenerative process of remyelination in MS and discuss the resulting options regarding remyelinating treatment strategies.
多发性硬化症(MS)是中枢神经系统最常见的慢性炎症性脱髓鞘疾病,其特征是免疫细胞浸润以及髓鞘和神经元的进行性损伤。近年来,神经元部分在多发性硬化症早期病理中的重要性日益明显。炎症早期的直接轴突损伤以及慢性脱髓鞘导致的神经元损伤是患者长期残疾发展的关键因素。将MS视为炎症性和神经退行性疾病对治疗具有重要意义,除了控制炎症外,使裸露的轴突重新髓鞘化以保护神经元免受损伤也是必要的。在此,我们综述了近期关于控制少突胶质细胞祖细胞分化和MS中髓鞘再生过程的关键分子和途径的分子见解,并讨论了由此产生的髓鞘再生治疗策略选项。