Molecular Effects of FDA-Approved Multiple Sclerosis Drugs on Glial Cells and Neurons of the Central Nervous System

Int J Mol Sci. 2020 Jun 13;21(12):4229. doi: 10.3390/ijms21124229.

Abstract

Multiple sclerosis (MS) is characterized by peripheral and central inflammatory features, as well as demyelination and neurodegeneration. The available Food and Drug Administration (FDA)-approved drugs for MS have been designed to suppress the peripheral immune system. In addition, however, the effects of these drugs may be partially attributed to their influence on glial cells and neurons of the central nervous system (CNS). We here describe the molecular effects of the traditional and more recent FDA-approved MS drugs Fingolimod, Dimethyl Fumarate, Glatiramer Acetate, Interferon-β, Teriflunomide, Laquinimod, Natalizumab, Alemtuzumab and Ocrelizumab on microglia, astrocytes, neurons and oligodendrocytes. Furthermore, we point to a possible common molecular effect of these drugs, namely a key role for NFκB signaling, causing a switch from pro-inflammatory microglia and astrocytes to anti-inflammatory phenotypes of these CNS cell types that recently emerged as central players in MS pathogenesis. This notion argues for the need to further explore the molecular mechanisms underlying MS drug action.

Keywords: astrocyte; dimethyl fumarate; fingolimod; glatiramer acetate; interferon-β; microglia; multiple sclerosis drug action; neuron; oligodendrocyte; teriflunomide.

Publication types

  • Review

MeSH terms

  • Drug Approval
  • Gene Expression Regulation / drug effects
  • Humans
  • Immunologic Factors / pharmacology*
  • Immunologic Factors / therapeutic use
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / immunology
  • NF-kappa B / metabolism
  • Neuroglia / drug effects
  • Neuroglia / metabolism*
  • Neurons / drug effects
  • Neurons / metabolism*
  • Signal Transduction / drug effects*
  • United States
  • United States Food and Drug Administration

Substances

  • Immunologic Factors
  • NF-kappa B

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