Neurotrophic Factors in Multiple Sclerosis: a Review of the Mechanism

The objective of this review is to examine the mechanistic roles of neurotrophic factors (NTFs) in the pathology of multiple sclerosis (MS) and their potential as therapeutic agents. MS is a chronic autoimmune disease of the central nervous system (CNS), characterized by immune-mediated demyelination, neurodegeneration, and chronic inflammation, leading to progressive neurological disability. Despite advances in disease-modifying therapies (DMTs) that reduce inflammation and relapse rates, there is a lack of treatments targeting neuronal repair and remyelination. Neurotrophic factors, including nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and ciliary neurotrophic factor (CNTF), have been shown to promote neurogenesis, axonal regeneration, and remyelination through specific signaling pathways. This review synthesizes findings from preclinical and clinical studies, focusing on the roles of neurotrophic factors in mitigating neuroinflammation, protecting neurons from apoptosis, and promoting oligodendrocyte progenitor cell (OPC) differentiation and remyelination. Challenges, including the delivery of NTFs across the blood-brain barrier (BBB), their short half-life, and the heterogeneous nature of MS, are discussed. Potential solutions, such as advanced delivery systems and personalized approaches, are highlighted. The review concludes that while neurotrophic factors hold promise as therapeutic agents in MS, further research is required to optimize their clinical application and overcome current barriers.