Basic Approaches in Therapy of Multiple Sclerosis (MS) and Related Diseases: Current Achievement and Prospective

Introduction: This overview is aimed at reevaluating fundamental approaches of current MS therapies with focus being placed on their targeted underlying immune, molecular and cellular mechanisms. Currently used therapies are discussed in regard to their mechanisms of action, clinical accomplishments and unwanted side effects and complications. Special emphasis is given to the current first generation Disease Modifying Therapies (DMT) and their actions at immune mechanisms of disease. Effects of DMT on CD4+Th1 cells and their associated cytokines and signaling pathways are discussed in more detail. Conclusion: Attention is paid to emerging role of a CD4 T cell chemotactic cytokine, IL-16 in regulation of relapsing MS and its model, experimental autoimmune encephalomyelitis (EAE). Immune mechanisms mediated by IL-16 are critically evaluated in the context of mechanisms of DMT and its potential as prospective MS therapy. In relation to clinical assessment of therapy, existing and prospective molecular biomarkers are highlighted and discussed where applicable.