With new cutting-edge technology such as gene-chip technology and new MRI-based advancements, the boundaries of multiple sclerosis as we know them today are being stretched to the limit. Numerous research activities directed at understanding its etiopathogenesis, halting its progression, restoring lost function, and development of a cure are underway with new strides being made every day. Major clinical trials are underway testing novel ways of treating multiple sclerosis with several drugs in advanced phases.
Laquinimod is an experimental immunomodulatory that alters T-cell populations to promote regulatory T-cell activity instead of the attack-focused Th1 response and also seems to play a role in the synthesis of neuroprotective molecules. Developed by Active Biotech and Teva, it is being investigated as an option for management of some forms of multiple sclerosis.
Teriflunomide, the active metabolite of leflunomide, is another immunomodulator under investigation for the treatment of multiple sclerosis. The proposed mechanism of action of teriflunomide is the blockade of pyrimidine synthesis that exerts a cytostatic effect on proliferating lymphocytes.
Other drugs under investigation for the treatment of multiple sclerosis include BG-12 (dimethyl fumarate), daclizumab (Zena pax), Alemtuzumab (Campath/Lemtrada), Rituximab (Rituxan), Ocrelizumab and Ibudilast.
New studies have shed more light on the role of lifestyle factors in influencing the development of multiple sclerosis. Vitamin D, whose synthesis is enhanced in bright sunlight, has been identified as a possible protective factor. It has been postulated that its role in immune system control safeguards against the dysregulation witnessed in multiple sclerosis. Studies have shown that people who spend more time in the sun are at a lower risk of developing multiple sclerosis.
Smoking has been implicated as a likely risk factor for the development of multiple sclerosis. The incidence of multiple sclerosis is higher among smokers as compared to non-smokers. Autopsy findings in smokers have demonstrated marked brain atrophy and shrinkage with numerous brain lesions. The reasons for the above observations are still shrouded in mystery.
