Related Experiment Video
Updated: May 11, 2026
Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
Published on: September 12, 2016
Treatment of primary progressive multiple sclerosis
1Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota 55902, USA. kantarci.orhun@mayo.edu
Abstract:
Primary progressive multiple sclerosis (MS) is primarily a neurodegenerative phenotype of MS. It is characterized by a predominant progressive disease course that largely determines the disability progression rather than the rare early superimposed relapses. Therefore, frustratingly, the immunomodulatory and immunosuppressive approaches have failed to have any meaningful impact on the disability progression in primary-progressive MS. Some benefit can still be obtained in select patients where notable number of superimposed relapses or significant ongoing subclinical magnetic resonance imaging activity may allow for immunomodulatory agents to work. Symptomatic treatment for MS should also not be overlooked in this population for impact on quality of life. Future work will likely focus more on the remyelinating and regenerative strategies to help this group of patients. Unfortunately, the lack of any warning symptoms hampers any future prevention trial in this population. However, inferring from previous studies in secondary progressive MS, a global effort to eliminate initiation of tobacco smoking in teenagers or young adults may also delay the onset of a progressive disease course in MS.
Insights
Primary progressive multiple sclerosis (MS) is a neurodegenerative disease where standard treatments show limited impact. Future research focuses on remyelination and regeneration, while smoking cessation may delay disease onset.
Area of Science:
- Neuroimmunology
- Neurodegeneration
- Multiple Sclerosis Pathophysiology
Background:
- Primary progressive multiple sclerosis (MS) is a neurodegenerative phenotype.
- Characterized by progressive disability rather than relapses.
- Current immunomodulatory treatments have limited efficacy in primary progressive MS.
Purpose of the Study:
- To review the challenges and future directions in managing primary progressive MS.
- To highlight the limited impact of current therapies on disability progression.
- To explore potential therapeutic strategies and preventive measures.
Main Methods:
- Review of existing literature on primary progressive MS.
- Analysis of treatment outcomes for immunomodulatory and immunosuppressive therapies.
- Discussion of emerging remyelinating and regenerative strategies.
- Consideration of preventive measures based on secondary progressive MS studies.
Main Results:
- Immunomodulatory and immunosuppressive therapies show minimal impact on disability progression in primary progressive MS.
- Symptomatic treatments can improve quality of life.
- Remyelinating and regenerative strategies are promising future directions.
- Eliminating tobacco smoking may delay the onset of progressive MS.
Conclusions:
- Primary progressive MS requires novel therapeutic approaches beyond current immunomodulatory strategies.
- Focus should shift towards neuroprotection, remyelination, and regeneration.
- Preventive strategies, such as smoking cessation, may play a role in delaying disease onset.
Related Concept Videos
01:19Multiple Sclerosis l: Introduction
01:20Myasthenia Gravis: Overview and Treatment
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which leads...
01:24Parkinson's Disease: Treatment
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...
01:22Alzheimer's Disease: Treatment
01:15Parkinson's Disease: Overview
02:56Treatment Resistant Cancers