Multiple sclerosis (MS) involves both immune attacks on myelin and failure to repair it. A new systematic review finds that the mTOR pathway sits at the center of both processes — but in opposing ways. Blocking mTOR reduces inflammation and may protect neurons, while activating mTOR promotes the remyelination that MS patients desperately need. This double-edged role means that simply inhibiting or activating mTOR could help one aspect of MS while worsening another. The review analyzed 90 studies from preclinical models and MS patient data and concludes that timing and disease stage are critical if mTOR-targeted therapies are ever to be used clinically. Current drugs like rapamycin, which inhibit mTOR, cannot yet be straightforwardly applied to MS without risking unintended consequences.
