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Inflammatory demyelinating diseases of the nervous system, such as multiple sclerosis or the Guillain-Barré syndrome represent severely disabling disorders, often seen by the neurologist, with still only limited means for therapeutical intervention. The underlying pathomechanisms remain in large part elusive, however mounting evidence suggests that enzymes of the family of matrix metalloproteinases are of relevance in the pathogenesis of these disorders. Experimental in vivo data as well as results from other medical fields emphasize that the selective inhibition of these proteases could be a promising therapeutical approach. The following review summarizes the role of matrix metalloproteinases in inflammatory demyelinating diseases of the central as well as peripheral nervous system and discusses the therapeutical application of synthetic inhibitors in these disorders.

Parenteral administration of fresh cells, frozen cells (snapfrozen cell suspensions) or lyophilized cells (sicca cells), is known as cellular or cell therapy. While the German Health Office (BGA) provisionally banned the use of dried cell preparations in 1987, injection of fresh cells is still allowed. There have been repeated reports of life-threatening, and even fatal, complications of this type of therapy. Since it involves the administration of heterologous biological material, most of the complications that have been observed have been of the allergic/hyperergic type resembling experimental allergic encephalomyelitis (EAE) and experimental allergic neuritis (EAN). When evaluating the risks of this form of alternative-medical treatment, the well-known risks of injection therapy must also be borne in mind. In the case of cell therapy, too, the hoped for effect must be weighed against the risks of the procedure, and our guiding principle must be: nil nocere.

Polyneuropathies are diffuse diseases of the peripheral nervous system. Pathological and anatomical investigations of the nerve fibres show that alterations of the peripheral axon and myelin are most significant at the distal end of the nerve fibres. Alcoholic polyneuropathy primarily affects the axon; during the chronic course of the disease, however, the myelin sheath is involved into the pathological process. Polyneuropathies are characterized by a deficiency and metabolic disturbance of the vitamins B1, B6 and B12. The vitamins of the B-group not only play an important role in the intermediate metabolism, but in paticular pathological situations high concentrations of the vitamins are necessary at a cellular and subcellular level. The experimental allergic neuritis (EAN) may be considered as a model of polyneuropathies characterized by disturbances of myelin metabolism. EAN was induced by the injection of human peripheral nerve homogenate the complete Freund's adjuvants. During EAN a marked reduction of phosphatidylinositol, sulfatides and serine-plasmalogen as well as a significant increase of phospholipase A2 activity could be observed.