Gesine Saher, PhD, Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany, discusses how lipid metabolism plays an important role in the remyelination of the central nervous system (CNS). In demyelinating CNS lesions, lipids such as cholesterol and fatty acids are released from myelin membranes as they degenerate. These lipids must be cleared efficiently to reduce local tissue damage, which is managed predominantly by CNS phagocytes, microglia, and macrophages. Excessive levels of lipids and myelin debris can overwhelm this system and cause the formation of foamy phagocytes. The density of foamy phagocytes is often associated with the severity of demyelinating disorders such as multiple sclerosis (MS). Once formed, foamy phagocytes can no longer participate in the clearing of lipid debris or in remyelination. They can also adopt an inflammatory phenotype which causes further damage. Several surrounding cell types, including oligodendrocytes, may then synthesize cholesterol which can encourage the repair of demyelinated lesions by activating lipid recycling. Lipid metabolism may be similarly important in replenishing energy deficiencies in the CNS. This interview took place at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress 2022 in Amsterdam, The Netherlands.
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