New directions in MS therapeutics: vehicles of hope

Basic immunological research has greatly expanded our understanding of the suspected immunopathology of multiple sclerosis (MS) and, more importantly, spawned a new generation of clinical trials evaluating dozens of immune-based therapies. Adhesion molecules are the furthest into development, although patient acceptance and neutralizing antibodies both support the development of small, orally available molecules. Progressive MS probably has a significant neurodegenerative component, so progress with neuroprotective strategies will require appropriate animal models, as well as more advanced clinical imaging techniques, such as brain atrophy and diffusion tensor. Dozens of therapies are in various stages of clinical development and results from these clinical studies will provide important tests of immune and inflammatory mechanisms of MS disease.