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Approaches to Remyelination Therapies in Multiple Sclerosis

  • Lindsey WooliscroftEmail author
  • Elizabeth Silbermann
  • Michelle Cameron
  • Dennis Bourdette
Multiple Sclerosis and Related Disorders (J Graves, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Multiple Sclerosis and Related Disorders

Abstract

Purpose of review

While there are a growing number of therapies targeting relapse prevention in multiple sclerosis (MS), there are no approved therapies promoting remyelination. Understanding endogenous myelin formation, remyelination strategies, pre-clinical models, and clinical outcomes is essential to the interpretation of current and future clinical trials of remyelinating agents.

Recent findings

Several recent clinical trials of remyelination therapies, including opicinumab, clemastine, and GSK239512, showed negative or modest results. These results could highlight challenges translating pre-clinical studies into subjects with MS and current strategies to measure remyelination.

Summary

Current approaches to remyelination include (1) blocking inhibitors of remyelination, (2) improving the clearance of myelin debris, (3) increasing the number of oligodendrocyte precursor cells (OPCs), and (4) stimulating OPC differentiation. To date, no therapies have led to robust remyelination. Future efforts to promote remyelination will likely require a combination of these mechanistic strategies.

Keywords

Remyelination Multiple sclerosis Oligodendrocyte precursor cell Opicinumab Clemastine GSK239512 

Notes

Acknowledgments

Dr. Wooliscroft would like to thank the Veterans Administration MS Center of Excellence-West for their support in her fellowship. Dr. Silbermann would like to thank the National MS Society for their support of her fellowship through a Sylvia Lawry Award.

Compliance with Ethical Standards

Conflict of Interest

Lindsey Wooliscroft and Elizabeth Silbermann each declare no potential conflicts of interest. Michelle Cameron reports consulting fees from Adamas Pharmaceuticals and Greenwich Biosciences outside the submitted work. Dennis Bourdette reports consultancy for reviewing patient medical records and providing opinion on treatments for Magellan Health Care and Best Doctors Inc. He also served as an expert witness on MS for the US Department of Justice, reports a bench research grant and collaborative center award from the National MS Society, and reports a founder’s stock valued at $1000 from Llama Therapeutics.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019

Authors and Affiliations

  • Lindsey Wooliscroft
    • 1
    • 2
    Email author
  • Elizabeth Silbermann
    • 1
  • Michelle Cameron
    • 1
    • 2
  • Dennis Bourdette
    • 1
  1. 1.Department of NeurologyOregon Health & Science UniversityPortlandUSA
  2. 2.Department of Veterans Affairs Portland Health Care SystemPortlandUSA

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