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Remyelination is the process of propagating oligodendrocyte precursor cells to form oligodendrocytes to create new myelin sheaths on demyelinated axons in the Central nervous system (CNS). This is a process naturally regulated in the body and tends to be very efficient in a healthy CNS. [ 1 ]
Myelinogenesis thus encompasses the process of transition between phases 3 and 4. [6] Upon initiation of myelinogenesis, each pioneer process forms lamellar extensions which extend and elaborate circumferentially around the target axon. This forms the first turn of the myelin sheath. [7]
The process of generating myelin is called myelination or myelinogenesis. In the CNS, oligodendrocyte progenitor cells (OPCs) differentiate into mature oligodendrocytes, which form myelin. In humans, myelination begins early in the 3rd trimester, [ 11 ] although only little myelin is present in either the CNS or the PNS at the time of birth.
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.
A remarkable finding in MS is that some Follicle-like aggregates appear in the meninges (composed by B-cells mostly infected with EBV [4]). These aggregates grow during the disease process and is mostly found in secondary progressive patients. Inflammation in the meninges has been found to be associated to gray mater (cortical) demyelination.
Myeloid-derived suppressor cells (MDSCs) are a recently discovered bone-marrow-derived cell type. They have characteristic of immature stem cells with immunomodulatory properties.
Human axon growth rates can reach 2 mm/day in small nerves and 5 mm/day in large nerves. [4] The distal segment, however, experiences Wallerian degeneration within hours of the injury; the axons and myelin degenerate, but the endoneurium remains. In the later stages of regeneration the remaining endoneurial tube directs axon growth back to the ...
N-cadherin is expressed in regions of active remyelination and may play an important role in generating a local environment conducive to remyelination. [24] N-cadherin agonists have been identified and observed to stimulate neurite growth and cell migration, key aspects of promoting axon growth and remyelination after injury or disease. [25]