Multiple sclerosis is characterized by inflammatory activity that results in destruction of the myelin sheaths that enwrap axons. The currently available medications for multiple sclerosis are predominantly immune-modulating and do not directly promote repair. White matter regeneration, or remyelination, is a new and exciting potential approach to treating multiple sclerosis, as remyelination repairs the damaged regions of the central nervous system. A wealth of new strategies in animal models that promote remyelination, including the repopulation of oligodendrocytes that produce myelin, has led to several clinical trials to test new reparative therapies. In this Review, we highlight the biology of, and obstacles to, remyelination. We address new strategies to improve remyelination in preclinical models, highlight the therapies that are currently undergoing clinical trials and discuss the challenges of objectively measuring remyelination in trials of repair in multiple sclerosis.

中文翻译：

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髓鞘再生疗法：多发性硬化症的新方向和新挑战

多发性硬化症的特征在于炎症活动，其导致包裹轴突的髓鞘破坏。当前用于多发性硬化症的药物主要是免疫调节的，不能直接促进修复。白质再生或髓鞘再生是治疗多发性硬化症的一种新颖且令人兴奋的潜在方法，因为髓鞘再生可修复中枢神经系统的受损区域。在动物模型中，有许多促进髓鞘再生的新策略，包括产生髓磷脂的少突胶质细胞的重新聚集，已经导致了几项临床试验来测试新的修复疗法。在这篇综述中，我们重点介绍了髓鞘再生的生物学及其障碍。我们提出了改善临床前模型中髓鞘再生的新策略，