Jan Hillert, MD, PhD: The Blood-Brain Barrier in Multiple Sclerosis

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The professor and senior physician in the department of clinical neuroscience at the Karolinska Institutet discussed the evolving understanding of the blood-brain barrier in MS, and what might still be left to uncover.

“In a way, the blood-brain barrier is important, but it isn’t as central to our thinking as it used to be. On the other hand, many of our drugs affect the blood-brain barrier in many ways. Even the first-iteration drugs do that to a certain extent.”

The blood-brain barrier has proven over the years to be an important topic in multiple sclerosis (MS) treatment. Studies have suggested that improvements in the understanding of its molecular mechanism of functioning could, in turn, lead to improvements in the quality of life of patients with MS, with recent literature pointing to calnexin as one possible target.^1,2

At ECTRIMS 2019, September 11-13 in Stockholm, Sweden, Jan Hillert, MD, PhD, professor and senior physician, clinical neuroscience, Karolinska Institutet, discussed the need for more information on the other aspects of the progression of MS outside of focal inflammation. Although the main targets of the disease are the processes taking place within the central nervous system, the need to pass through the blood-brain barrier to impact these processes proves the validity of this conversation in MS.³

When discussing this topic on-site with NeurologyLive's sister publication AJMC, Hillert shared insight into how the conversation around the blood-brain barrier in MS has evolved with the clinical understanding of it, and what might still be left to uncover.

For more coverage of ECTRIMS 2019, click here.

REFERENCE

1. Ortiz GG, Pacheco-Moisés FP, Macías-Islas MÁ, et al. Role of the blood-brain barrier in multiple sclerosis. Arch Med Res. 2014 Nov;45(8):687-97. doi: 10.1016/j.arcmed.2014.11.013.

2. Jung J, Eggleton P, Robinson A, et al. Calnexin is necessary for T cell transmigration into the central nervous system. JCI Insight. 2018;3(5):e98410. doi: 10.1172/jci.insight.98410.

3. Hillert J. The road not (yet) taken: targeting new pathways of MS pathophysiology. Presented at: ECTRIMS 2019; September 11-13; Stockholm, Sweden. Satellite Symposium 5.