Targeting Oligodendrocyte Dynamics and Remyelination: Emerging Therapies and Personalized Approaches in Multiple Sclerosis Management.

Tarun Sharma, Sidharth Mehan, Aarti Tiwari, Zuber Khan, Ghanshyam Das Gupta, Acharan S Narula
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Abstract

Multiple sclerosis [MS] is a progressive autoimmune condition that primarily affects young people and is characterized by demyelination and neurodegeneration of the central nervous system [CNS]. This in-depth review explores the complex involvement of oligodendrocytes, the primary myelin- producing cells in the CNS, in the pathophysiology of MS. It discusses the biochemical processes and signalling pathways required for oligodendrocytes to function and remain alive, as well as how they might fail and cause demyelination to occur. We investigate developing therapeutic options that target remyelination, a fundamental component of MS treatment. Remyelination approaches promote the survival and differentiation of oligodendrocyte precursor cells [OPCs], restoring myelin sheaths. This improves nerve fibre function and may prevent MS from worsening. We examine crucial parameters influencing remyelination success, such as OPC density, ageing, and signalling pathway regulation [e.g., Retinoid X receptor, LINGO-1, Notch]. The review also examines existing neuroprotective and antiinflammatory medications being studied to see if they can assist oligodendrocytes in surviving and reducing the severity of MS symptoms. The review focuses on medicines that target the myelin metabolism in oligodendrocytes. Altering oligodendrocyte metabolism has been linked to reversing demyelination and improving MS patient outcomes through various mechanisms. We also explore potential breakthroughs, including innovative antisense technologies, deep brain stimulation, and the impact of gut health and exercise on MS development. The article discusses the possibility of personalized medicine in MS therapy, emphasizing the importance of specific medicines based on individual molecular profiles. The study emphasizes the need for reliable biomarkers and improved imaging tools for monitoring disease progression and therapy response. Finally, this review focuses on the importance of oligodendrocytes in MS and the potential for remyelination therapy. It also underlines the importance of continued research to develop more effective treatment regimens, taking into account the complexities of MS pathology and the different factors that influence disease progression and treatment.

以少突胶质细胞动力学和再髓鞘化为目标:多发性硬化症治疗中的新兴疗法和个性化方法。
多发性硬化症(MS)是一种主要影响年轻人的进行性自身免疫性疾病,以中枢神经系统(CNS)的脱髓鞘和神经变性为特征。这篇深度综述探讨了中枢神经系统中主要的髓鞘生成细胞--少突胶质细胞在多发性硬化症病理生理学中的复杂参与。它讨论了少突胶质细胞发挥功能和保持活力所需的生化过程和信号通路,以及它们如何可能失效并导致脱髓鞘的发生。我们研究了针对多发性硬化症治疗的基本组成部分--再髓鞘化的治疗方案。再髓鞘化方法可促进少突胶质前体细胞(OPCs)的存活和分化,恢复髓鞘。这能改善神经纤维功能,防止多发性硬化症恶化。我们研究了影响再髓鞘化成功与否的关键参数,如 OPC 密度、老化和信号通路调控(如视黄醇 X 受体、LINGO-1、Notch)。综述还探讨了正在研究的现有神经保护和抗炎药物,以了解这些药物能否帮助少突胶质细胞存活并减轻多发性硬化症症状的严重程度。综述的重点是针对少突胶质细胞髓鞘代谢的药物。改变少突胶质细胞的新陈代谢与逆转脱髓鞘和通过各种机制改善多发性硬化症患者的预后有关。我们还探讨了潜在的突破,包括创新的反义技术、脑深部刺激以及肠道健康和运动对多发性硬化症发展的影响。文章讨论了多发性硬化症治疗中个性化药物的可能性,强调了基于个体分子特征的特定药物的重要性。研究强调需要可靠的生物标志物和改进的成像工具来监测疾病进展和治疗反应。最后,本综述重点讨论了少突胶质细胞在多发性硬化症中的重要性以及再髓鞘化疗法的潜力。它还强调了继续研究开发更有效治疗方案的重要性,同时考虑到多发性硬化症病理的复杂性以及影响疾病进展和治疗的不同因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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