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Mechanisms of Disease Progression

Chapter

Abstract

A clear understanding of the mechanisms which underpin disease ­progression is required in order to develop rational therapies for this stage of the disease. Up until a few years ago, the major emphasis in drug development for MS has been to target inflammation and as a result, the pathophysiology of inflammatory demyelination appears better understood than processes occurring during disease progression. However, since the burgeoning of anti-inflammatory therapies for MS and the progress that has been made for relapse prevention, attention has recently been turned to address the issue of disease progression. While representing a major therapeutic challenge, significant progress in understanding the mechanisms of MS disease progression has occurred in recent years.

Specifically, an increased recognition of the importance of axonal injury in progressive disease has emerged. Axonal injury appears to account for much of the disability seen during the progressive phase and, importantly, may be irreversible once certain structural changes have appeared in axons. This is in contrast to myelin injury which is, to some extent, reparable. Thus has emerged the recognition that strategies to protect axons early in the disease are required. Potential strategies to protect axons will be discussed at the end of this chapter after a discussion of the mechanisms of axonal injury in MS.

Keywords

Axon Demyelination Inflammation Trophic Neuroprotection Oligodendrocyte 

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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Department of NeurologyFrenchay HospitalBristolUK

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