Potential Avenues for Remyelination in Multiple Sclerosis: Bruce Bebo, PhD

WATCH TIME: 4 minutes

"Early trials of promyelinating agents have shown that remyelination in humans is possible, I think the roadblock is demonstrating the clinical benefit of those approaches. There's a lot of work going on right now in determining what's the best timing for treatment, the best dose, best methodology for measuring myelin repair in humans."

Multiple sclerosis (MS) is an inflammatory, demyelinating, and neurodegenerative disease of the central nervous system (CNS), with a prevalence of 50-300 cases per 100,000 individuals. Over the past few decades, the treatment of MS has been transformed through advancements in immunotherapies that efficiently reduce disease activity and clinical relapses; however, the prevention of disability progression has been a challenge.

Demyelination is pathognomonic in MS, and restoring myelin—remyelination or myelin regeneration—is a therapeutic option that improves both nerve conduction velocity and metabolic support to the underlying axon. Several of those in the field have invested resources into remyelinating approaches. Most recently, a phase 1b study assessing liothyronine, a thyroid hormone replacement therapy, showed biological effect in a single-center study of patients with relapsing or progressive MS. Previous research has shown that thyroid hormones may play a direct role in remyelination and repair in the adult CNS by promoting maturation of oligodendrocytes.

Organizations like the National MS Society have also taken efforts to understand how to restore function and reverse damage in patients with MS. The Pathways to Cures Roadmap, developed through the engagement of scientific thought leaders and those affected by MS, is a global initiative aimed at accelerating scientific breakthroughs leading to cures for MS. Bruce Bebo, PhD, executive vice president of the National MS Society, recently sat down to discuss the initiative, including the efforts toward remyelination. He spoke on the challenges of understanding true clinical benefit of remyelinating approaches and the need for improved imaging techniques.