Signals to promote myelin formation and repair

Nat Rev Neurol. 2010 May;6(5):276-87. doi: 10.1038/nrneurol.2010.37. Epub 2010 Apr 20.

Abstract

The myelin sheath wraps large axons in both the CNS and the PNS, and is a key determinant of efficient axonal function and health. Myelin is targeted in a series of diseases, notably multiple sclerosis (MS). In MS, demyelination is associated with progressive axonal damage, which determines the level of patient disability. The few treatments that are available for combating myelin damage in MS and related disorders, which largely comprise anti-inflammatory drugs, only show limited efficacy in subsets of patients. More-effective treatment of myelin disorders will probably be accomplished by early intervention with combinatorial therapies that target inflammation and other processes-for example, signaling pathways that promote remyelination. Indeed, evidence suggests that such pathways might be impaired in pathology and, hence, contribute to the failure of remyelination in such diseases. In this article, we review the molecular basis of signaling pathways that regulate myelination in the CNS and PNS, with a focus on signals that affect differentiation of myelinating glia. We also discuss factors such as extracellular molecules that act as modulators of these pathways. Finally, we consider the few preclinical and clinical trials of agents that augment this signaling.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / pharmacology
  • Anti-Inflammatory Agents / therapeutic use
  • Humans
  • Models, Biological
  • Multiple Sclerosis / drug therapy
  • Multiple Sclerosis / pathology*
  • Myelin Sheath / drug effects
  • Myelin Sheath / pathology
  • Myelin Sheath / physiology*
  • Nerve Regeneration / drug effects
  • Nerve Regeneration / physiology*
  • Nerve Tissue Proteins / genetics
  • Nerve Tissue Proteins / metabolism
  • Nervous System Physiological Phenomena* / drug effects
  • Signal Transduction / drug effects
  • Signal Transduction / physiology*

Substances

  • Anti-Inflammatory Agents
  • Nerve Tissue Proteins