EAN 2022 | The inflammatory process in MS

Hans Lassmann, MD, Medical University of Vienna, Vienna, Austria, describes two types of inflammation that occur in multiple sclerosis (MS), which develop in parallel but are partially independent. The first gives rise to classical active demyelinated plaques and dominates in acute and relapsing MS. The other type of inflammation is sitting within the central nervous system (CNS) and is no longer controlled by the peripheral immune system. This type of inflammation is already present in the early stages of MS but gradually increases with disease duration. Only recently, technologies able to show the dynamics of smoldering lessions became available. While treating acute relapses is relatively simple, the treatment of smoldering pathology is challenging. The treatment needs to target the inflammation in the CNS hiding behind the blood-brain barrier (BBB), which requires developing new pharmacological therapies that pass the BBB. This interview took place at the 2022 Congress of the European Academy of Neurology (EAN) in Vienna, Austria.