Multiple Sclerosis: Novel Treatments for Repair

Multiple sclerosis is an autoimmune disease involving the central nervous system (CNS) that involves white matter lesions. The white matter lesions are composed of broken myelin sheaths. Myelin allows for the action potentials to jump from node to node, sending signals throughout the brain to allow for proper functioning. When myelin sheaths are destroyed, this can cause numerous symptoms, including impaired motor and cognitive function, due to slower rates of signaling in the brain. The cognitive deficits are often subtle but can have a significant effect on quality of life. Other symptoms of MS include fatigue and sensory issues, such as numbness and tingling. 

Foamy macrophages in myelin are an important part of multiple sclerosis (Haidar, 2022). These foamy macrophages are especially prevalent in the center of MS lesions, and can occur when the autophagy process goes awry. Accumulation of these myelin-derived lipids can lead to more inflammation in the brain and exhibit a more aggressive type of multiple sclerosis. 

This increased inflammation can prevent remyelination, the brain’s natural ability to repair broken signaling pathways, utilizing precursor cells of oligodendrocytes to form oligodendrocytes that create new myelin sheaths. It has been found that trehalose-treatment not only reduces lipid accumulation and inflammation, but can also help promote remyelination (Haidar, 2022).  Trehalose has also been previously studied for other neurological diseases.

Current treatment for multiple sclerosis is aimed at preventing disease progression and controlling symptoms. Currently, the most effective treatments for MS include Kesimpta, which is a pen that can be injected into the bloodstream once per month, and Ocrevus, a medication that requires going to a doctor’s office for an infusion. New research has demonstrated that lipophagy induction, the fusion of lipid droplets with lysosomes, shows promise in repair for multiple sclerosis.