Dimethyl Fumarate Reduces Inflammation in Chronic Active Multiple Sclerosis Lesions

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Nicole Zinger1, Gerald Ponath1, Elizabeth Sweeney1

  • 1From the Department of Neurology (N.Z., L.Z., S.A.G.), Weill Cornell Medicine, New York; Department of Neurology (G.P., C.H.L., D.P.), Yale School of Medicine, New Haven, CT; Department of Population Health Sciences (E.S., I.D.), and Department of Radiology (T.D.N., A.D., J.C., Y.W., S.A.G.), Weil Cornell Medicine, New York; Department of Medicine (L.T.), Yale New Haven Hospital, New Haven, CT; Feil Family Brain and Mind Institute (S.A.G.), Weill Cornell Medicine, New York; and Lee Kong Chian School of Medicine (C.H.L.), Nanyang Technological University, Singapore.

Neurology(R) Neuroimmunology & Neuroinflammation
|January 20, 2022
PubMed
Abstract

Insights

Dimethyl fumarate (DMF) reduces iron in multiple sclerosis (MS) lesions more effectively than glatiramer acetate (GA). DMF also decreases microglial activation and iron content in vitro, suggesting it targets inflammation in MS.

Area of Science:

  • Neuroimmunology
  • Neuroinflammation
  • Magnetic Resonance Imaging (MRI)

Background:

  • Multiple sclerosis (MS) involves chronic active lesions with iron accumulation.
  • Assessing the impact of disease-modifying therapies (DMTs) on lesion characteristics is crucial.

Purpose of the Study:

  • To compare the effects of dimethyl fumarate (DMF) and glatiramer acetate (GA) on iron content in MS lesions.
  • To investigate the in vitro effects of DMF and GA on human microglia.

Main Methods:

  • Retrospective observational study of 34 MS patients treated with DMF or GA, analyzing quantitative susceptibility mapping (QSM) data.
  • In vitro study using human microglia treated with DMF or GA to assess iron content and activation.

Main Results:

  • DMF treatment showed a significant reduction in lesion susceptibility (iron marker) compared to GA.
  • DMF, but not GA, reduced microglial inflammatory activation and iron content in vitro.

Conclusions:

  • DMF effectively reduces iron in chronic active MS lesions, likely by decreasing microglial activity.
  • QSM-derived susceptibility changes in rim lesions serve as a potential in vivo biomarker for DMF's effect on microglial activity.

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