Cognition

Patrick Vermersch: Chronic Inflammation and PIRA in Multiple Sclerosis

Patrick Vermersch discusses the role of chronic compartmentalised inflammation and innate immunity in progression independent of relapse activity.

Watch the interview

Progression independent of relapse activity (PIRA) is increasingly recognised as an important contributor to disability accumulation in Multiple Sclerosis (MS).

In this interview, Patrick Vermersch explores the inflammatory mechanisms that may drive PIRA. He discusses the potential contributions of lymphocytes, microglia, astrocytes and other myeloid cells, as well as the challenges of evaluating chronic inflammation in vivo.

Key points discussed include:

The distinction between chronic inflammation associated with PIRA and focal inflammation associated with relapses.
The role of compartmentalised inflammation in MS progression.
The possible contributions of adaptive and innate immunity.
The involvement of microglia, astrocytes, myeloid cells and meningeal lymphoid structures.
The need for clinical, imaging and biomarker tools to assess chronic inflammation in vivo.

What in your view is driving early PIRA and which markers are more promising to detect it in everyday practice?

* Please note that all the captions were generated automatically. If they do not appear, click on CC in the navigation.

Key messages from Patrick Vermersch

Chronic compartmentalised inflammation may be a major driver of PIRA.
Focal inflammation is more closely associated with relapses and the accumulation of Magnetic Resonance Imaging lesions.
Innate immune mechanisms involving microglia, astrocytes and other myeloid cells may contribute to chronic inflammation.
Adaptive immune cells and meningeal lymphoid structures may also play a role.
Clinical tools, imaging and biomarkers are needed to evaluate chronic inflammation and its contribution to PIRA in vivo.