ANTI-INFLAMMATORY NEUROPHARMACOLOGY IN MULTIPLE SCLEROSIS: CURRENT DRUGS AND FUTURE DIRECTIONS
Main Article Content
Keywords
Multiple Sclerosis; Neuroinflammation; Anti-inflammatory Neuropharmacology; Neuroprotection; Disease-Modifying TherapiesMultiple Sclerosis; Neuroinflammation; Anti-inflammatory Neuropharmacology; Neuroprotection; Disease-Modifying Therapies
Abstract
Background
Multiple Sclerosis is a chronic immune-mediated disorder of the central nervous system, driven primarily by neuroinflammation and oxidative injury. Despite significant advances in disease-modifying therapies, persistent inflammation and progressive neurodegeneration remain key challenges. The emerging field of anti-inflammatory neuropharmacology offers new strategies aimed at immune modulation, neuroprotection, and remyelination.
Objectives
This retrospective study aimed to evaluate the clinical, diagnostic, and imaging profiles of MS patients to identify patterns of neuroinflammatory activity and disability progression, and to relate these findings to current and emerging pharmacological interventions.
Methods
A record-based retrospective analysis was conducted on confirmed MS cases. Demographic, diagnostic, and neuroimaging data including Oligoclonal Bands, evoked potentials, and MRI lesion distributions were evaluated. Disability progression was measured using the Expanded Disability Status Scale (EDSS). Descriptive statistical analysis was performed using Microsoft Excel.
Results
Among 273 patients, females constituted 61.5% with a mean age of 38.4 ± 10.2 years. Oligoclonal Bands were positive in 59.3% of cases, and MRI showed predominant periventricular (68.5%) and cortical (54.2%) lesions. The mean EDSS increased from 1.4 ± 0.6 to 2.2 ± 0.8, indicating gradual neurological decline.
Conclusion
The study highlights the central role of neuroinflammation in MS progression and underscores the importance of integrating biomarker-driven, neuroprotective, and regenerative pharmacological approaches for achieving sustained disease control and functional preservation.
References
2. Brambilla, R. (2019). The contribution of astrocytes to the neuroinflammatory response in multiple sclerosis and experimental autoimmune encephalomyelitis. Acta neuropathologica, 137(5), 757-783.
3. Breiteneder, H., Peng, Y. Q., Agache, I., Diamant, Z., Eiwegger, T., Fokkens, W. J., ... & Akdis, C. A. (2020). Biomarkers for diagnosis and prediction of therapy responses in allergic diseases and asthma. Allergy, 75(12), 3039-3068.
4. Cohen, J. A., Trojano, M., Mowry, E. M., Uitdehaag, B. M., Reingold, S. C., & Marrie, R. A. (2020). Leveraging real-world data to investigate multiple sclerosis disease behavior, prognosis, and treatment. Multiple sclerosis journal, 26(1), 23-37.
5. Cui, L. Y., Chu, S. F., & Chen, N. H. (2020). The role of chemokines and chemokine receptors in multiple sclerosis. International immunopharmacology, 83, 106314.
6. Duarte-Delgado, N. P., Vasquez, G., & Ortiz-Reyes, B. L. (2019). Blood-brain barrier disruption and neuroinflammation as pathophysiological mechanisms of the diffuse manifestations of neuropsychiatric systemic lupus erythematosus. Autoimmunity reviews, 18(4), 426-432.
7. Ganji, A., Monfared, M. E., Shapoori, S., Nourbakhsh, P., Ghazavi, A., Ghasami, K., & Mosayebi, G. (2020). Effects of interferon and glatiramer acetate on cytokine patterns in multiple sclerosis patients. Cytokine, 126, 154911.
8. Gatta, V., Mengod, G., Reale, M., & Tata, A. M. (2020). Possible correlation between cholinergic system alterations and neuro/inflammation in multiple sclerosis. Biomedicines, 8(6), 153.
9. Huhn, K., Engelhorn, T., Linker, R. A., & Nagel, A. M. (2019). Potential of sodium MRI as a biomarker for neurodegeneration and neuroinflammation in multiple sclerosis. Frontiers in neurology, 10, 84.
10. Kaur, D., Sharma, V., & Deshmukh, R. (2019). Activation of microglia and astrocytes: a roadway to neuroinflammation and Alzheimer’s disease. Inflammopharmacology, (4), 663-677.
11. Krysko, K. M., Graves, J. S., Rensel, M., Weinstock‐Guttman, B., Rutatangwa, A., Aaen, G., ... & US Network of Pediatric MS Centers. (2020). Real‐world effectiveness of initial disease‐modifying therapies in pediatric multiple sclerosis. Annals of neurology, 88(1), 42-55.
12. Makhani, N., Lebrun, C., Siva, A., Narula, S., Wassmer, E., Brassat, D., ... & Observatoire Francophone de la Sclérose en Plaques (OFSEP), Société Francophone de la Sclérose en Plaques (SFSEP), the Radiologically Isolated Syndrome Consortium (RISC) and the Pediatric Radiologically Isolated Syndrome Consortium (PARIS). (2019). Oligoclonal bands increase the specificity of MRI criteria to predict multiple sclerosis in children with radiologically isolated syndrome. Multiple Sclerosis Journal–Experimental, Translational and Clinical, 5(1), 2055217319836664.
13. Mangale, V., McIntyre, L. L., Walsh, C. M., Loring, J. F., & Lane, T. E. (2019). Promoting remyelination through cell transplantation therapies in a model of viral‐induced neurodegenerative disease. Developmental Dynamics, 248(1), 43-52.
14. Myhr, K. M., Torkildsen, Ø., Lossius, A., Bø, L., & Holmøy, T. (2019). B cell depletion in the treatment of multiple sclerosis. Expert opinion on biological therapy, 19(3), 261-271.
15. Nociti, V. (2020). What is the role of Brain derived neurotrophic factor in Multiple Sclerosis neuroinflammation?. Neuroimmunology and Neuroinflammation, 7(3), 291-299.
16. Nzogang, P. M., & Donkeng, M. B. (2020). Neuroprotection: the way of anti-inflammatory agents. Neuroprotection-New Approaches and Prospects, 90509.
17. Padureanu, R., Albu, C. V., Mititelu, R. R., Bacanoiu, M. V., Docea, A. O., Calina, D., ... & Buga, A. M. (2019). Oxidative stress and inflammation interdependence in multiple sclerosis. Journal of clinical medicine, 8(11), 1815.
18. Pegoretti, V., Swanson, K. A., Bethea, J. R., Probert, L., Eisel, U. L., & Fischer, R. (2020). Inflammation and oxidative stress in multiple sclerosis: consequences for therapy development. Oxidative medicine and cellular longevity, 2020(1), 7191080.
19. Rehman, M. U., Wali, A. F., Ahmad, A., Shakeel, S., Rasool, S., Ali, R., ... & Khan, R. (2019). Neuroprotective strategies for neurological disorders by natural products: an update. Current neuropharmacology, 17(3), 247-267.
20. Roggeri, A., Schepers, M., Tiane, A., Rombaut, B., van Veggel, L., Hellings, N., ... & Vanmierlo, T. (2020). Sphingosine-1-phosphate receptor modulators and oligodendroglial cells: beyond immunomodulation. International journal of molecular sciences, 21(20), 7537.
21. Saidu, N. E. B., Kavian, N., Leroy, K., Jacob, C., Nicco, C., Batteux, F., & Alexandre, J. (2019). Dimethyl fumarate, a two‐edged drug: current status and future directions. Medicinal research reviews, 39(5), 1923-1952.
22. Sedighiyan, M., Djafarian, K., Dabiri, S., Abdolahi, M., & Shab-Bidar, S. (2019). The effects of omega-3 supplementation on the expanded disability status scale and inflammatory cytokines in multiple sclerosis patients: A systematic review and meta-analysis. CNS & Neurological Disorders-Drug Targets-CNS & Neurological Disorders), 18(7), 523-529.
23. Shamaa, A., Abdallah, A. N., Bahr, M. M., & El-Tookhy, O. S. (2020). A review: Multiple Sclerosis Treatment: Current Strategies and Future Hopes. Alexandria Journal of Veterinary Sciences, 66(2).
24. Sulhan, S., Lyon, K. A., Shapiro, L. A., & Huang, J. H. (2020). Neuroinflammation and blood–brain barrier disruption following traumatic brain injury: pathophysiology and potential therapeutic targets. Journal of neuroscience research, 98(1), 19-28.
25. Tommasin, S., Giannì, C., De Giglio, L., & Pantano, P. (2019). Neuroimaging techniques to assess inflammation in multiple sclerosis. Neuroscience, 403, 4-16.
26. Van Langelaar, J., Rijvers, L., Smolders, J., & Van Luijn, M. M. (2020). B and T cells driving multiple sclerosis: identity, mechanisms and potential triggers. Frontiers in immunology, 11, 760.
27. Villoslada, P., & Steinman, L. (2020). New targets and therapeutics for neuroprotection, remyelination and repair in multiple sclerosis. Expert opinion on investigational drugs, 29(5), 443-459.

