A review : multiple sclerosis treatment: current strategies and future hopes

Abstract EN

Multiple sclerosis (MS) is an autoimmune chronic disease affecting the neurons of the central nervous system (CNS).

The immune system attacks the myelin sheath covering the nerve fibers, initiating transmission problems between the brain and the rest of the body and ultimately causes permanent damage to the nerves.

The characteristic pathologic finding of MS is multiple focal areas of myelin loss within the CNS called plaques or lesions, accompanied by variable gliosis and inflammation with relative axonal preservation.

The multiple active “plaques” are infiltrated by macrophages containing myelin debris.

The MS is classified into 4 categories: Relapsing–remitting which is considered the most common (about 85% of cases), Secondary progressive, Primary progressive and Progressive-relapsing.

Current treatments of MS with varying diseasemodifying agents aim to shorten the duration of acute relapses and decrease relapses frequency.

Until now, no curative FDA-approved drugs exist, but there are 8 FDAapproved therapeutic agents that can reduce the disease progression in the relapsing forms.

The available drugs are either immunosuppressive or immunomodulatory drugs which block or delay MS progression.

Regenerative medicine via Mesenchymal Stem Cells (MSCs) could play an important role in treatment of damaged neural tissue as MSCs not only have the ability for neuro-generation but also have immunoregulative function which can control and treat MS.

Exosomes derived from MSCs are expected to offer a better alternative to the possible drawbacks of using MSCs such as tumorigenicity and immune rejection.

Current strategies to deal with MS are based on two lines of handling; medications that aim to shorten the duration of acute relapses and decrease relapses frequency by its immunomodulatory effect, and those aim to relieve MS symptoms to maintain the function and improve life quality.

This review aims to point out the current strategies used to treat multiple sclerosis, their effectiveness, and the possible new strategies of treatment.