New strategies for the treatment of multiple sclerosis

Background: Multiple sclerosis is a chronic inflammatory demyelinating dise ase of the central nervous system. With a prevalence of 0.1-0.15% in German y multiple sclerosis is the most common cause of severe disability in young adults. Pathogenesis: Epidemiological and family studies demonstrate the role of en vironmental and genetic factors in the pathogenesis of multiple sclerosis. Based on those observations and findings in experimental animal models, it is believed that multiple sclerosis is caused by an autoimmune process. How ever, target antigens and mechanisms leading to tissue destruction are larg ely unknown. Therapy: Since the efficacy of current immunomodulatory and immunosuppressi ve therapies (beta-interferons, glatiramer acetate, mitoxantrone) is limite d, it is necessary to develop new strategies for the treatment of multiple sclerosis. To reach this goal, a much better understanding of disease patho genesis is necessary which takes into account the clinical, paraclincial an d histopathological heterogeneity of the disease. Conclusion: Only further intensive research activity on basic mechanisms of disease pathogenesis and a consequent development of resulting therapeutic strategies - from animal models to phase III studies - will result in sign ificant improvement of the long-term course of multiple sclerosis.