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MS : Innovation and concrete results

Increasingly, we are able to effectively treat active inflammatory MS lesions, which have specific MRI characteristics as they capture an intravenously injected contrast agent - gadolinium - which enables the focal opening of the blood-brain barrier. We now have drugs which make it possible to prevent over 90% of such active lesions from occurring. However, we know that there are other, chronically active lesions, which do not capture the contrast agent and which extend slowly but surely, centrifugally, around formerly active lesions. 

These chronic lesions, partly active at the edge and inactive at the centre, have a propensity to “creep” and are therefore partly responsible for the gradual increase in the severity of the disease. The periphery of these lesions contains macrophages that very gradually destroy the myelin sheaths. These macrophages are loaded with iron which is probably produced by the destruction of the oligodendrocytes that manufacture the myelin sheath. Recently, MRI technology has enabled this thin ring of iron to be detected around formerly active lesions.

The work of Prof. Tom Vanden Berghe focuses particularly on the toxicity of iron, which can cause cell death, and on the ways in which this toxicity can be countered by the use of new molecules. These slow-growing lesions, which are known as slow expanding lesions (SEL), develop inside brains when the blood-brain barrier has once more become impermeable. A basic issue, then, is delivering the requisite therapeutic molecules to the brain.

Prof. Anne des Rieux is working on a new method of getting molecules to penetrate the brain via the nasal mucous membrane, the upper part of which is separated from the olfactory bulbs only by the cribriform plate, a thin bone with multiple holes. Nanomolecule sprays containing therapeutic substances could enable drugs to be introduced directly into the brain, bypassing the blood-brain barrier.

This research is periodically the focus of scientific meetings organized by the Belgian Charcot Foundation. Belgian teams that have benefited from Charcot funds will present their results with the participation of renowned overseas specialists. To obtain valid scientific advances, it is essential that researchers exchange and communicate with each other.

Prof. Dr Christian Sindic