Therapeutic Plasma Exchange and Multiple Sclerosis Dysregulations: Focus on the Removal of Pathogenic Circulatory Factors and Altering Nerve Growth Factor and Sphingosine-1-Phosphate Plasma Levels

Multiple sclerosis (MS) is predominantly an immune-mediated disease of the central nervous system (CNS) unknown etiology with a possible genetic predisposition and effect certain environmental factors. It generally accepted that begins autoimmune inflammatory reaction targeting oligodendrocytes followed by rapid depletion their regenerative capacity subsequent permanent neurodegenerative changes disability. Recent research highlights role B lymphocytes corresponding IgG IgM autoantibodies in newly forming MS lesions. Thus, removal along modulation bioactive molecules to improve neuroprotection using therapeutic plasma exchange (TPE) becomes utmost importance. Recently, it has been proposed determine levels precise effects both beneficial harmful components serum patients undergoing TPE serve as markers for appropriate protocols. In this review we discuss some relevant examples, focusing on pathogenic circulating factors altering nerve growth factor sphingosine-1-phosphate TPE. Altered reviewed molecular compounds response reflect successful reduction pro-inflammatory burden at expense increase anti-inflammatory potential circulatory CNS compartments.