Mechanisms of action of glatiramer acetate in the treatment of multiple sclerosis

This chapter is arranged with three sections. The introduction (. Section 1) includes subsections dealing with the history of experimental allergic encephalomyelitis (EAE) and of the development of copolymer ?1, which led to the development of glatiramer acetate as a pharmacological product. Section 2 introduces glatiramer as an immunomodulator, with two subsections. The first outlines the impact on adaptive immune responses, and the second, the so-called "shift" from Th1 to Th2 helper T cell responses. Section 3 deals with the drug as a neuroprotective agent. The first subsection deals with induction of neurotrophic molecules by glatiramer and the second deals with the drugs impact on the innate immune system; a new focus for research on mechanisms of "switching off" damage by macrophages and microglial cells and "turning on" repair and regeneration of axons and myelin. Figures 1 and 2 show the relationships of the elements of immune function discussed in this chapter.