ECTRIMS 2025 | The impact of iron metabolism on MS disease activity and progression
Alessandro Cagol, MD, University of Basel, Basel, Switzerland, shares insights into the impact of iron metabolism on multiple sclerosis (MS) disease activity and progression. He highlights that there is a decrease in iron accumulation within the thalamus of patients with MS compared with healthy controls, and accumulation of iron can aid in identifying paramagnetic rim lesions. This interview took place at the 41st Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Barcelona, Spain.
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Transcript
Okay, that is definitely an extremely important topic to further characterize the pathophysiology of multiple scerosis and the pathological changes. Indeed, there are several studies and there is accumulating evidence that iron homeostasis plays a crucial role also in the pathophysiology of multiple scerosis and there are several studies that are now focusing on better understanding this role. For sure there is evidence that iron changes occur in several different structures of the brain and this especially true for example in the deep gray matter where for example changes in iron homeostasis within the thalamus have been extensively investigated and several studies have reported that indeed there is a decrease of iron accumulation within the thalamus of patient with multiple scerosis compared to healthy controls...
Okay, that is definitely an extremely important topic to further characterize the pathophysiology of multiple scerosis and the pathological changes. Indeed, there are several studies and there is accumulating evidence that iron homeostasis plays a crucial role also in the pathophysiology of multiple scerosis and there are several studies that are now focusing on better understanding this role. For sure there is evidence that iron changes occur in several different structures of the brain and this especially true for example in the deep gray matter where for example changes in iron homeostasis within the thalamus have been extensively investigated and several studies have reported that indeed there is a decrease of iron accumulation within the thalamus of patient with multiple scerosis compared to healthy controls. And this depletion of iron also correlates with the severity of the disability. While we know from other neurogenerative disorders that there is also accumulation of iron in specific condition and specific locations. But of course probably the the the most important reason why iron is becoming more and more investigated in the field of multiple scerosis is through and is due to the ability of detecting paramagnetic rim lesions which are a specific subset of white matter lesions characterized by an accumulation of iron at the lesion periphery within iron-related macrophages and microglia. And these lesions are extremely important both from diagnostic point of view as they can support the new revision of the McDonald criteria in the diagnosis of multiple scerosis, paramagnetic rim lesions, but they are also of course extremely valuable from the prognostic point of view.
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