ABSTRACT
Multiple sclerosis (MS) is a complex disease with multifactorial pathogenesis and different clinical courses. Inammation, oxidative stress, and redox processes are important factors in MS pathophysiology. Additionally, oxidative stress appears to provide an important link between environmental and genetic risk factors. Investigations of effective antioxidative therapy for MS are very reasonable due to the heterogeneous nature of this disease. Over the last decade, various therapies and exogenous compounds were designed to affect immune response in the central nervous system (CNS). Recent studies suggested that neuroprotection is strictly connected with signaling pathways involving special redox-sensitive transcription nuclear factor (erythroid-derived 2)-related factor 2 (Nrf2). Moreover, it creates a promising target for future MS therapies like new oral treatment
Abstract .......................................................................................................................................... 167 13.1 Introduction .......................................................................................................................... 168 13.2 CNS Cell Types and Their Role in MS ................................................................................ 169
13.2.1 Oligodendrocytes ...................................................................................................... 169 13.2.2 Astrocytes ................................................................................................................. 169 13.2.3 Microglial Cells ........................................................................................................ 169 13.2.4 Blood-Brain Barrier ................................................................................................. 173
13.3 Nitric Oxide and Neural Function ........................................................................................ 173 13.4 MS Traditional Treatment ..................................................................................................... 174 13.5 Mechanisms of Oxidative Damage in MS ............................................................................ 174 13.6 Possible Antioxidative Therapies in MS ............................................................................... 176
13.6.1 Fumaric Acid Esters ................................................................................................. 176 13.6.2 Melatonin .................................................................................................................. 178
13.7 Other Therapies .................................................................................................................... 178 13.7.1 Cannabinoids ............................................................................................................ 178 13.7.2 Vitamin D ................................................................................................................. 179 13.7.3 Cryostimulation ........................................................................................................ 179
13.8 Conclusion ............................................................................................................................ 180 Abbreviations ................................................................................................................................. 180 References ...................................................................................................................................... 181
with fumaric acid ester that has been recently approved for the treatment of early stage of MS ( relapsing-remitting (RR)).
