Quinpramine--a promising compound for treating immune-mediated demyelination of the nervous system

Multiple sclerosis (MS) is a chronic demyelinating autoimmune disease of the central nervous system. Different therapeutic options are available, but all require parenteral application and some expose patients to potentially lethal adverse effects. The response to treatment remains variable and often incomplete. Thus, the search for novel therapeutic agents is ongoing and relevant. The chimeric compound quinpramine-generated from its precursor substances imipramine and quinacrine-has recently demonstrated clinical efficacy in experimental autoimmune encephalomyelitis (EAE), an animal model for MS. Mechanistic considerations and recent experimental data suggest that intracellular redistribution of antigen-presenting molecules and cholesterol-rich membrane domains may account for the clinical efficacy of this drug. This article summarizes available treatment options in MS and explains why the candidate compound quinpramine may transfer from bench to bedside in the near future.