So we currently KNOW NOTHING ABOUT WHITE MATTER REPAIR. I don't even know how white matter damage is objectively identified.
Mechanisms and repair strategies for white matter degeneration in CNS injury and diseases
Highlights
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White matter degeneration is a hallmark of neurotrauma and several leading diseases of the central nervous system.
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White matter degeneration is convergence of complex pathophysiological events that collectively lead to oligodendrocyte damage, and axon degeneration and demyelination.
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Extensive research has been performed to identify the molecular mechanisms underpinning white matter degeneration, and to design therapeutic strategies for axon regeneration and remyelination.
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Although a plethora of neuroprotective and neuroregenerative strategies have been developed in recent years with promising results in preclinical models, more work is required to translate these strategies to clinical applications.
Abstract
White matter degeneration is an important pathophysiological event of the central nervous system that is collectively characterized by demyelination, oligodendrocyte loss, axonal degeneration and parenchymal changes that can result in sensory, motor, autonomic and cognitive impairments. White matter degeneration can occur due to a variety of causes including trauma, neurotoxic exposure, insufficient blood flow, neuroinflammation, and developmental and inherited neuropathies. Regardless of the etiology, the degeneration processes share similar pathologic features. In recent years, a plethora of cellular and molecular mechanisms have been identified for axon and oligodendrocyte degeneration including oxidative damage, calcium overload, neuroinflammatory events, activation of proteases, depletion of adenosine triphosphate and energy supply. Extensive efforts have been also made to develop neuroprotective and neuroregenerative approaches for white matter repair. However, less progress has been achieved in this area mainly due to the complexity and multifactorial nature of the degeneration processes. Here, we will provide a timely review on the current understanding of the cellular and molecular mechanisms of white matter degeneration and will also discuss recent pharmacological and cellular therapeutic approaches for white matter protection as well as axonal regeneration, oligodendrogenesis and remyelination.
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