Skip To Main Content
For UK Healthcare Professionals Only. This site is created and funded by Sanofi.

Advancing the understanding of smouldering and acute neuroinflammation in MS1,2

Optimal MS care includes a comprehensive approach that addresses both acute and smouldering neuroinflammation throughout the course of a patient’s disease.1,2
 

Both acute and smouldering neuroinflammation may occur from disease onset. Addressing both processes early on could help prevent disease progression and impact long-term disability outcomes in patients with MS.1,3,4

Illustration showing concurrent pathways of acute and smoldering neuroinflammation and the effects of these pathways in the brain with images of microglia, b-cells, t-cells, lesions and the blood brain barrier.  

Occurring exclusively in the CNS, smoldering neuroinflammation has been largely inaccessible. However, acute neuroinflammation can be effectively reduced by currently available DMTs.1,7-10

One way to impact smouldering neuroinflammation, occurring exclusively in the CNS, is to cross the blood-brain barrier and act directly on microglia to reduce neuroinflammatory and neurodegenerative processes.8

 

Headshot of Celia Oreja-Guevara, MD PHD

Hear from the experts

Celia Oreja-Guevara, MD, PhD, discusses the underlying biology of acute and smouldering neuroinflammation at EAN 2023

Watch now

References:

  1. Giovannoni G, Popescu V, Wuerfel J, et al. Smouldering multiple sclerosis: the ‘real MS’. Ther Adv Neurol Disord. 2022;15:1-18. doi:10.1177/17562864211066751

  2. Cree BAC, Hollenbach JA, Bove R, et al; University of California, San Francisco MS-Epic Team. Silent progression in disease activity-free relapsing multiple sclerosis. Ann Neurol. 2019;85(5):653-666.

  3. Simpson A, Mowry EM, Newsome SD. Early aggressive treatment approaches for multiple sclerosis. Curr Treat Options Neurol. 2021;23:19. doi:10.1007/s11940-021-00677-1

  4. Scalfari A. MS can be considered a primary progressive disease in all cases, but some patients have superimposed relapses - Yes. Mult Scler. 2021;27(7):1002-1004.

  5. Yong VW. Microglia in multiple sclerosis: protectors turn destroyers. Neuron. 2022;110(21):3534-3548.

  6. Kuhlmann T, Moccia M, Coetzee T, et al. Multiple sclerosis progression: time for a new mechanism-driven framework. Lancet Neurol. 2023;22(1):78-88.

  7. Häusser-Kinzel S, Weber MS. The role of B cells and antibodies in multiple sclerosis, neuromyelitis optica, and related disorders. Front Immunol. 2019;10:201. doi:10.3389/fimmu.2019.00201

  8. Correale J, Halfon MJ, Jack D, Rubstein A, Villa A. Acting centrally or peripherally: a renewed interest in the central nervous system penetration of disease-modifying drugs in multiple sclerosis. Mult Scler Relat Disord. 2021;56:103264. doi:10.1016/j.msard.2021.103264

  9. Geladaris A, Torke S, Weber MS. Bruton’s Tyrosine Kinase inhibitors in multiple sclerosis: pioneering the path towards treatment of progression? CNS Drugs. 2022;36(10):1019-1030.
  10. Absinta M, Lassmann H, Trapp BD. Mechanisms underlying progression in multiple sclerosis. Curr Opin Neurol. 2020;33(3):277-285.

MAT-XU-2500917 v1.0 May 2025