The Coming Age of Brain Repair: Remyelination & Neuroprotection in the Central Nervous System - UCSF

Summary

Myelin is the protective sheath around axons, the parts of neurons that carry signals. It supports brain development and function but is damaged in multiple sclerosis (MS). UCSF researchers are investigating ways to restore myelin and protect axons, with the goal of limiting disability.

The research program brings basic scientists and clinicians together to develop and test brain-repair treatments. In 2013, researchers led by Jonah Chan and May Fang explored whether existing drugs could encourage oligodendrocyte precursor cells to develop into myelin-producing oligodendrocytes. One candidate was clemastine, an antihistamine.

In a recovery study, the team used the visual system to assess patients and gauge repair while accounting for whether enough axons remained to support remyelination. The study provided evidence of brain repair and suggested possible benefits for maintaining axons.

Other areas of work include identifying biomarkers in body fluids to track disease and treatment, studying why peripheral nervous system axons can regenerate while central nervous system axons generally cannot, and exploring ways to activate neuronal recovery programs. The researchers emphasize translational work that connects laboratory biology to clinical care.

Research Approaches and Projects

• Test existing drugs for remyelination: Investigate whether treatments such as clemastine can promote the development of myelin-producing cells.
• Measure repair through the visual system: Use visual-system measures to assess treatment effects and the availability of axons that could be remyelinated.
• Find biomarkers: Study body fluids for measurable indicators of disease and treatment response, with the aim of bringing useful biomarkers into clinical practice.
• Investigate axon regeneration: Compare repair in peripheral nerves with the limited regenerative capacity of central nervous system axons, including the role of neuronal stress signaling.
• Develop a trial for infants: In a planned long-term study, give a remyelination-promoting agent to infants with premature white matter damage and monitor their neurological outcomes.
• Use digital health measures: Explore tools that track daily activity, mobility, cognition, typing speed, and speech quality, potentially helping assess recovery in trials.

The researchers see potential for brain-repair therapies to address unmet needs in MS and possibly other conditions, including Alzheimer’s disease.

Researchers and Sources Featured

• Jonah Chan
• May Fang
• Ari Green
• UCSF Department of Neuroimmunology and Glial Biology