Mechanisms of myelin repair, MRI techniques and therapeutic opportunities in multiple sclerosis
Mechanisms of myelin repair, MRI techniques and therapeutic opportunities in multiple sclerosis
复制标题
多发性硬化症的髓磷脂修复机制、MRI 技术和治疗机会
DOI：
10.1016/j.msard.2021.103407
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发表时间：
2022
影响因子：
4
通讯作者：
Sato Douglas Kazutoshi
中科院分区：
文献类型：
--
作者：
Sommer Rafael Canani;Hata Junichi;Rimkus Carolina de Medeiros;Klein da Costa Bruna;Nakahara Jin;Sato Douglas Kazutoshi
多发性硬化症(MS)是一种慢性中枢神经系统炎症性脱髓鞘疾病。再髓鞘形成过程需要脱髓鞘区域少突胶质细胞前体细胞(OPC)的激活、迁移和分化。慢性脱髓鞘病变的代谢功能障碍损害了OPC的活性，小胶质细胞对髓鞘碎片的清除量随年龄增长而减少，促进OPC分化的因子分泌减少。常规磁共振成像(MRI)序列对无髓鞘和有髓鞘病变的区分能力有限。基于磁化转移率(MTR)、髓鞘水含量(MWF)和弥散张量成像(DTI)的高级MRI序列已被用于临床试验中评估再髓鞘形成。最近，Q空间髓鞘映射(QMM)已被用于实验和探索性临床研究。中心之间高度可靠和标准化的髓鞘特异性MRI序列的改进将使改善髓鞘再生的新疗法得到更准确的评估。这些新的促进髓鞘再生的治疗单独或与目前的选择相结合，可能会降低多发性硬化症长期残疾的风险。
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS). The remyelination process requires the activation, migration and differentiation of oligodendrocyte progenitor cells (OPC) in demyelinated areas. The metabolic dysfunction in chronic demyelinating lesions impairs the activation of OPCs, the myelin debris clearance by microglia decreases with age, along with diminished secretion of factors promoting OPC differentiation. Conventional magnetic resonance imaging (MRI) sequences have limited ability to differentiate unmyelinated and remyelinated lesions. Advanced MRI sequences based on magnetization transfer ratio (MTR), myelin water fraction (MWF) and diffusion tensor imaging (DTI) have been used to evaluate remyelination in clinical trials. More recently, the q-space myelin map (qMM) has been used on experimental and exploratory clinical studies. The improvement of myelin-specific MRI sequences with high reliability and standardization among centers will allow a more accurate evaluation of new therapies to improve remyelination. These new remyelination promoting treatments alone or in combination with current options may reduce the risk of long-term disability in MS.