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The processes underlying remyelination are under investigation in the hope of finding treatments for demyelinating diseases, such as multiple sclerosis. As of 2022 the status of possible remyelination acceleration is of trials only, [2] with side effects of possible drugs one limiting issue. [3]
Cerebrolysin (developmental code name FPF-1070) is an experimental mixture of enzymatically-treated peptides derived from pig brain whose constituents can include brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), nerve growth factor (NGF), and ciliary neurotrophic factor (CNTF).
[16] [40] In 2013 one further oral drug, dimethyl fumarate -or BG12- (which is an improved version of fumaric acid, an already existing drug), was approved by the FDA. Another oral drug, cladribine, was approved in Russia and Australia in 2010. Its application was rejected by the FDA and EMEA in 2011, due to safety concerns.
In the future, we’d like to see a combination of drugs that can prevent immune attacks, repair myelin, and protect nerves from further damage.” If further trials are successful, perhaps PIPE ...
The drug targets the role of macrophages in disease progression. [26] [27] Manipulating thyroid hormone levels may become a viable strategy to promote remyelination and prevent irreversible damage in MS patients. [28] It has also been shown that intranasal administration of apotransferrin (aTf) can protect myelin and induce remyelination. [29]
A repair process, called remyelination, takes place in early phases of the disease, but the oligodendrocytes are unable to completely rebuild the cell's myelin sheath. Repeated attacks lead to successively less effective remyelinations, until a scar-like plaque is built up around the damaged axons.
Immunosuppressive drugs are often of the cytotoxic (chemotherapy) class, including rituximab (Rituxan) which targets B cells, and cyclophosphamide, a drug which reduces the function of the immune system. Ciclosporin has also been used in CIDP but with less frequency as it is a newer approach. [40]
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