**Neuroprotection: A New Therapeutic Approach of Relapsing Remitting Multiple Sclerosis**

Juan Espinosa-Parrilla, Marco Pugliese, Nicole Mahy and Manuel J Rodríguez

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/63730

#### **Abstract**

[103] Xing B, 2015; Xing B, Bachstetter AD, Van Eldik LJ. Inhibition of neuronal p38α, but not p38β MAPK, provides neuroprotection against three different neurotoxic insults. J

[104] Kotelnikova E, Bernardo-Faura M, Silberberg G, Kiani NA, Messinis D, et al. Signaling networks in MS: a systems-based approach to developing new pharmacological

therapies. Mult Scler. 2015 Feb;21(2):138–46. doi:10.1177/1352458514543339

Mol Neurosci. 2015;55(2):509–18. doi:10.1007/s12031-014-0372-x.

306 Trending Topics in Multiple Sclerosis

Neurodegenerative changes occurring early from primary acute immune-mediated inflammation support the hypothesis that multiple sclerosis (MS) is a complex disease. Axonal loss progresses with the disease course and represents the principal driver of disability. In this context, the pursuit of neuroprotective therapies in multiple sclerosis provides new valid alternatives that could significantly impact on disease progression and neurodegenerative changes, including the promotion of restoration of myelin sheaths through the remyelination process. This chapter reviews promising drugs with proposed neuroprotective or neuroregenerative effects that are currently approved or in clinical trials for the treatment of multiple sclerosis. Although the chapter high‐ lights the diazoxide action on neuroinflammation and the results of a clinical trial with this drug, the review also includes other molecules with oral or parenteral administra‐ tion.

**Keywords:** relapsing-remitting multiple sclerosis, disease-modifying drugs, neuro‐ protection, neuroregeneration, neuroinflammation, central nervous system

#### **1. Introduction**

Immunosuppressive and immunomodulatory drugs have been designed for years to treat multiple sclerosis (MS), as it was considered the most appropriate approach to balance the effects of the patients' immune reaction. However, the new data recently offered by basic and clinical research increase our understanding of this complex disease, allowing changes in its therapeutic approach. As a consequence, the first disease-modifying drug with a suggested

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neuroprotective mechanism of action has been recently approved, broadening and improv‐ ing the therapeutic landscape against MS.

In this chapter, we review new drugs with proposed neuroprotective or neuroregenerative effects that are currently approved or in clinical trials for MS treatment. Although we highlight the diazoxide action on neuroinflammation and the results of a clinical trial with this drug, the review also includes other molecules with oral or parenteral administration.

The articles analysed for this review were selected using PubMed database filtered by English language. Clinical trials were selected at the ClinicalTrials.gov database. Studies in the database labelled as "unknown status" were excluded. The initial search was done in Decem‐ ber 2015.
