The changing landscape of optic neuritis: a narrative review

Lott, Lindsey B. De; Bennett, Jeffrey L.; Costello, Fiona

doi:10.1007/s00415-020-10352-1

Cited by 38 publications

(49 citation statements)

References 89 publications

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“…Unfortunately, for a sizable proportion of patients, corticosteroids are not sufficient, and another immunotherapy must be quickly instituted. By convention, plasma exchange (PE) and immunoadsorption (IA) are considerations, since these treatments rapidly remove serum autoantibodies, complement, and pro-inflammatory cytokines [ 1 , 14 – 16 ]. There is uncertainty, however, about exactly when these adjunctive therapies should be started for acute relapse management.…”

Section: Acute Relapse Managementmentioning

confidence: 99%

Contemporary management challenges in seropositive NMOSD

Costello

Burton

2022

J Neurol

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Neuromyelitis optica spectrum disorders (NMOSD) is an inflammatory disorder of the central nervous system that presents unique management challenges. Neurologic disability in NMOSD is directly linked to acute attacks, therefore, relapse prevention is an overarching goal of care. To this end, identifying effective biomarkers that predict relapse onset and severity is of critical importance. As treatment becomes more precision-based and patient-centred, clinicians will need to be familiar with managing circumstances of particular vulnerability for patients with NMOSD, including infection, pregnancy, and the post-partum phase. The discovery of the pathogenic aquaporin-4 Immunoglobulin G (AQP4 IgG) autoantibody almost 20 years ago ultimately distinguished NMOSD as an autoimmune astrocytopathy and helped spearhead recent therapeutic advancements. Targeted therapies, including eculizumab, satralizumab, and inebilizumab, approved for use in aquaporin-4 immunoglobulin G (AQP4 IgG) seropositive patients with NMOSD will likely improve outcomes, but there are formidable costs involved. Importantly, seronegative patients continue to have limited therapeutic options. Moving forward, areas of research exploration should include relapse prevention, restorative therapies, and initiatives that promote equitable access to approved therapies for all people living with NMOSD.

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Section: Acute Relapse Managementmentioning

confidence: 99%

Contemporary management challenges in seropositive NMOSD

Costello

Burton

2022

J Neurol

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“…MicroRNAs mediate post-transcriptional gene silencing and are involved in cellular activities including proliferation, differentiation, and migration, as well as disease initiation and disease progression. MicroRNA appears to mediate most EV effects [ 159 ] by three known mechanisms: [ 1 ] Binding the 3’UTR of their target mRNA, silencing the gene and blocking translation, [ 2 ] Translational repression by cleaving and degrading mRNA, [ 3 ] De-adenylation and degradation of mRNAs [ 160 ]. The miRNA processing endonuclease Dicer is a member of the ribonuclease III family that functions in the RNA interference pathway to cleave long double stranded RNA molecules into small RNAs including miRNA and siRNA [ 161 , 162 ].…”

Section: Main Textmentioning

confidence: 99%

“…Optic neuritis (ON) is an inflammatory condition of the optic nerve often associated with central nervous system demyelinating disorders including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), anti-myelin oligodendrocyte glycoprotein associated disease (MOGAD), as well as other systemic autoimmune disorders [ 1 ]. ON is characterized by inflammation and demyelination of the optic nerve and inner retinal damage [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Emerging concepts in the treatment of optic neuritis: mesenchymal stem cell-derived extracellular vesicles

et al. 2021

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Background Optic neuritis (ON) is frequently encountered in multiple sclerosis, neuromyelitis optica spectrum disorder, anti-myelin oligodendrocyte glycoprotein associated disease, and other systemic autoimmune disorders. The hallmarks are an abnormal optic nerve and inflammatory demyelination; episodes of optic neuritis tend to be recurrent, and particularly for neuromyelitis optica spectrum disorder, may result in permanent vision loss. Main Body Mesenchymal stem cell (MSC) therapy is a promising approach that results in remyelination, neuroprotection of axons, and has demonstrated success in clinical studies in other neuro-degenerative diseases and in animal models of ON. However, cell transplantation has significant disadvantages and complications. Cell-free approaches utilizing extracellular vesicles (EVs) produced by MSCs exhibit anti-inflammatory and neuroprotective effects in multiple animal models of neuro-degenerative diseases and in rodent models of multiple sclerosis (MS). EVs have potential to be an effective cell-free therapy in optic neuritis because of their anti-inflammatory and remyelination stimulating properties, ability to cross the blood brain barrier, and ability to be safely administered without immunosuppression. Conclusion We review the potential application of MSC EVs as an emerging treatment strategy for optic neuritis by reviewing studies in multiple sclerosis and related disorders, and in neurodegeneration, and discuss the challenges and potential rewards of clinical translation of EVs including cell targeting, carrying of therapeutic microRNAs, and prolonging delivery for treatment of optic neuritis. Graphical Abstract

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“…Central nervous system (CNS) autoimmune demyelinating disorders present with a broad clinical disease spectrum, including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), anti-myelin oligodendrocyte glycoprotein-associated disease (MOGAD), acute disseminated encephalomyelitis (ADEM), and glial fibrillary acidic protein (GFAP)-associated meningoencephalomyelitis. The autoantigen is unknown in MS and ADEM, while it has been identified for NMSOD (aquaporin-4 water channel (AQP4)), MOGAD (myelin oligodendrocyte glycoprotein), and GFAP-associated meningoencephalomyelitis [ 1 , 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Mesenchymal Stem Cell-Derived Extracellular Vesicles and Their Therapeutic Use in Central Nervous System Demyelinating Disorders

Allegretta

D’Amico

Manuti

et al. 2022

IJMS

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Autoimmune demyelinating diseases—including multiple sclerosis, neuromyelitis optica spectrum disorder, anti-myelin oligodendrocyte glycoprotein-associated disease, acute disseminated encephalomyelitis, and glial fibrillary acidic protein (GFAP)-associated meningoencephalomyelitis—are a heterogeneous group of diseases even though their common pathology is characterized by neuroinflammation, loss of myelin, and reactive astrogliosis. The lack of safe pharmacological therapies has purported the notion that cell-based treatments could be introduced to cure these patients. Among stem cells, mesenchymal stem cells (MSCs), obtained from various sources, are considered to be the ones with more interesting features in the context of demyelinating disorders, given that their secretome is fully equipped with an array of anti-inflammatory and neuroprotective molecules, such as mRNAs, miRNAs, lipids, and proteins with multiple functions. In this review, we discuss the potential of cell-free therapeutics utilizing MSC secretome-derived extracellular vesicles—and in particular exosomes—in the treatment of autoimmune demyelinating diseases, and provide an outlook for studies of their future applications.

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The changing landscape of optic neuritis: a narrative review

Cited by 38 publications

References 89 publications

Contemporary management challenges in seropositive NMOSD

Contemporary management challenges in seropositive NMOSD

Emerging concepts in the treatment of optic neuritis: mesenchymal stem cell-derived extracellular vesicles

Mesenchymal Stem Cell-Derived Extracellular Vesicles and Their Therapeutic Use in Central Nervous System Demyelinating Disorders

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