Glatiramer acetate for the treatment of multiple sclerosis: evidence for a dual anti-inflammatory and neuroprotective role

Journal of the Neurological Sciences
R Liblau

Abstract

Although it was originally synthesised to induce experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis, glatiramer acetate (GA) is actually used in the treatment of this human disease. Serendipity thus was responsible for the discovery of the therapeutic properties of what has become one of the only two first-line therapies currently approved for relapsing-remitting multiple sclerosis. Despite being discovered over forty years ago, novel aspects of the mechanism of action of GA are still being uncovered today. Initially, the immunomodulatory effects of GA were believed to involve high-affinity binding of the polypeptide to MHC Class II molecules on antigen-presenting cells. Subsequently, it was demonstrated that GA activated a specific population of GA-reactive T cells of a type-2 helper (Th2) phenotype, promoting an antiinflammatory environment and the preferential migration of GA-specific Th2 cells into the central nervous system, leading to decreased local inflammation through 'bystander suppression'. More recently, it has been shown that GA-reactive Th2 cells will secrete neurotrophins, important factors for neuronal survival and for axonal protection, in the central nervous system. Moreover, perh...Continue Reading

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