Emerging therapies to target CNS pathophysiology in multiple sclerosis

Area of Science:

• Neuroscience
• Immunology
• Pharmacology

Background:

• The therapeutic landscape for multiple sclerosis (MS) is rapidly evolving, necessitating new treatment strategies.
• Current treatments for relapsing-remitting MS have limitations, with significant unmet needs in addressing progressive disease mechanisms and repairing central nervous system (CNS) injury.

Purpose of the Study:

• To review emerging therapies for MS that target CNS-specific processes.
• To highlight agents aimed at limiting progressive disease injury and promoting tissue repair in the CNS.

Main Methods:

• Focus on novel agents for MS that are known or presumed to penetrate the CNS.
• Review therapies targeting inflammation, neurodegeneration, neuroprotection, and remyelination/axonal regeneration.
• Consider agents in early-stage clinical development for MS.

Main Results:

• Emerging therapies modulate adaptive and innate CNS-compartmentalized inflammation involving immune cells, microglia, and astrocytes.
• Agents targeting degenerative mechanisms, conferring neuroprotection, and promoting oligodendrocyte precursor cell differentiation, remyelination, and axonal regeneration are discussed.
• The review focuses on therapies with potential to address key therapeutic gaps in MS management.

Conclusions:

• Novel therapeutic strategies are under investigation to address progressive multiple sclerosis and CNS repair.
• These emerging agents target diverse mechanisms including inflammation, neuroprotection, and regeneration.
• Further clinical development is crucial to evaluate the efficacy of these promising therapies for MS patients.