Multiple sclerosis (MS) is the most prevalent demyelinating disease of the central nervous system (CNS). It affects over 400,000 people in the USA alone and is a common disease world wide. This book will cover a new and emerging field in the development of strategies to treat MS. Until now, the only therapies available for MS treatment have been those directed against inflammation and the immune attack on the CNS. Other treatments are used for symptomatic relief. Remyelination of the CNS has been purely an experimental procedure to date, with many years of research on experimental remyelination in animal models of MS and other myelin disease. As more becomes known about the underlying pathophysiology of MS, it has become apparent that axon loss is a critical component of this primary demyelinating disease and that remyelination of axons at risk, i.e. demyelinated axons, may be the best neuroprotection available. Thus the idea of repairing myelin to both restore conduction to demyelinated fibers, as well as protecting them against future loss, is being seriously explored as a translational therapy. The purpose of this book will be to bring together the experts in the field to discuss what is required to move forward into the clinical application of tissue repair and neuroprotection. The book will begin with a discussion on myelin and the myelinating cell of the CNS and the current state-of-the- art on the cell and molecular biology of the cell, with particular reference toward myelin repair. The book will conclude with a chapter(s) on the clinical application of new myelin repair and axonal protection therapies and the methods by which these new therapies will be evaluated in clinical trials.

Myelin Repair and Neuroprotection in Multiple Sclerosis presents an up-date on the translational potential of promoting remyelination in multiple sclerosis (MS). A number of research frontiers still exist in this challenging disease. The cause remains elusive, preventing breakthroughs in its prevention. The move towards oral immunomodulatory therapies has been a major advance, as has the finding of new genes linked to susceptibility that may open the door to new therapeutic approaches. However, a frontier that has been making significant strides in recent years has been that surrounding the neurobiology of myelin regeneration and axon protection: such have been the advances that clinical translation is on the cusp of being achieved. Two broad approaches to therapeutic enhancement of remyelination are envisaged: promoting endogenous remyelination by targeting cells present in the CNS, or, replacing lost myelinating cells from exogenous sources. Current research on oligodendrocyte biology, the pathology of MS, imaging of lesions and the biology of remyelination are paving the way toward opening this new translational frontier. Professor Duncan and Professor Franklin have assembled a broad group of experts in the fields of glial cell biology, neuropathology, radiology and clinical neurology to provide the background toward taking remyelination from experimented models into MS patients.