Demyelinating diseases and potential repair strategies

Int J Dev Neurosci, 2007 · DOI: 10.1016/j.ijdevneu.2007.02.002 · Published: May 1, 2007

Simple Explanation

Demyelination, the loss of the myelin sheath around nerve fibers, is associated with neurological disorders like multiple sclerosis (MS), spinal cord injury, and nerve compression. MS lesions often involve axon loss, making remyelination and neuroprotection key therapeutic goals. Experimental cellular transplantation has shown promise in animal models by remyelinating axons and improving functional outcomes. This involves using different myelin-forming cell types to repair damaged areas. Understanding these models and cell-based strategies offers opportunities to develop clinical studies for remyelination and neuroprotection in humans suffering from demyelinating diseases.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Cell transplantation, using cells like oligodendrocytes, Schwann cells, and olfactory ensheathing cells (OECs), has demonstrated remyelination and improved conduction in animal models.
2
OECs, easily harvested from the nasal mucosa, can remyelinate both central and peripheral axons, making them attractive candidates for autologous cell therapy in clinical studies.
3
Transplantation of OECs into injured spinal cords is associated with axonal regeneration, functional improvement, and the development of nodes of Ranvier, crucial for impulse conduction.

Research Summary

Demyelination is a hallmark of several neurological disorders, including multiple sclerosis (MS), spinal cord injury, and nerve compression. Therapeutic strategies aim to promote remyelination and protect vulnerable axons. Experimental models, such as EAE and chemically-induced demyelination, are crucial for studying potential therapies. Cell transplantation using myelin-forming cells like oligodendrocytes, Schwann cells, and olfactory ensheathing cells (OECs) has shown promise in these models. OEC transplantation has demonstrated potential for axonal regeneration, remyelination, and functional improvement in spinal cord injuries, leading to clinical studies. Future research should focus on the reparative potential of cell transplantation in chronic inflammatory CNS lesions.

Practical Implications

Clinical Translation

Cell-based therapies hold promise for treating demyelinating diseases like MS and spinal cord injury, but further research is needed to optimize cell types, delivery methods, and long-term efficacy.

Remyelination Strategies

Understanding the mechanisms of endogenous myelin repair and how to stimulate endogenous progenitors could lead to new pharmacological approaches for promoting remyelination.

Axonal Protection

Since axonopathy is common in MS lesions, cellular transplantation strategies should also aim to protect axons from further damage and promote axonal regeneration.

Study Limitations

1
Rodent models of demyelination may not fully replicate the complexities of human demyelinating diseases.
2
The behavior and reparative potential of cell transplantation into chronic gliotic lesions are still unknown.
3
The precise mechanisms responsible for functional recovery after OEC transplantation are not fully understood.

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