Abstract
Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease that involves an intricate interaction between the central nervous system and the immune system. Nevertheless, its etiology is still unknown. MS exhibits different clinical courses: recurrent episodes with remission periods (‘relapsing-remitting’) that can evolve to a ‘secondary progressive’ form or persistent progression from the onset of the disease (‘primary progressive’). The discovery of an effective treatment and cure has been hampered due to the pathological and clinical heterogeneity of the disease. Historically, MS has been considered as a disease exclusively of white matter. However, patients with progressive forms of MS present with cortical lesions associated with meningeal inflammation along with physical and cognitive disabilities. The pathogenesis of the cortical lesions has not yet been fully described. Animal models that represent both the cortical and meningeal pathologies will be critical in addressing MS pathogenesis as well as the design of specific treatments. In this review, we will address the state-of-the-art diagnostic and therapeutic alternatives and the development of strategies to discover new therapeutic approaches, especially for the progressive forms.
Acknowledgments
Carina C. Ferrari is a member of the Research Career of the National Council of Scientific and Technological Research (CONICET), Argentina. Berenice A. Silva is a fellow of the Baron Foundation and received a Fiorini Foundation Award.
Funding: This work was supported by the CONICET, PIP grant 11220080100106 (C.C.F.), PICT-2012-0656 (FONCyT; C.C.F.), the Baron Foundation, and the University Institute, Italian Hospital, Buenos Aires, Argentina.
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