New Treatment Options for Multiple Sclerosis Explored

Scientists map pathological progress of disease.

Researchers for the first time have documented the pathological progress of multiple sclerosis (MS), from early to late stage with the role played by inflammatory and neurodegenerative processes, which could lead to new treatment options.

Currently, one approach to categorizing MS regards it as a nervous system disease that is inflammatory throughout, which is responsible for the resulting neurodegenerative damage. The other approach states MS as progressing from an inflammatory condition into a neurodegenerative condition.

For the current study, researchers demonstrated that MS includes both factors, while the inflammatory process drives the disease from onset through the end. The study also found that neurodegenerative processes occur in the progressive late phase, which damages the brain.

"The inflammatory process, which can be treated effectively in the early stages, becomes less pronounced with age,” lead researcher Hans Lassmann, head of the Department of Neuroimmunology at the MedUni Vienna, said in a press release. “However the neurodegenerative damage increases. This also explains why drugs that initially work well later lose their effectiveness."

Damage from MS becomes amplified during the later stages of the disease, as neurodegenerative damage triggers microglial cells that drive the disease forward, as oxygen radicals form and destroy lipids and proteins in the brain. Meanwhile, the mitochondria suffers damage, which in combination with normal brain aging and the deposition of iron leads to further damage.

As a result of the new research into these mechanisms, the study notes that new treatment approaches may be realized. The researchers noted that over the next decade, the progressive stage of the disease may be slowed by fighting these amplification mechanisms.

"There are two routes. First, drugs could be developed that have an anti-inflammatory effect in the brain too, not just suppressing the defense response in the blood and lymphatic organs,” Lassman said. “Secondly, neuroprotective treatments could be developed that preventively block the amplification mechanisms and damage to the mitochondria, thereby preventing consequential damage."