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Mammalian nervous systems depend crucially on myelin sheaths covering the axons. In the central nervous
system, myelin sheaths consist of lipid structures which are generated from the membrane of oligodendrocytes (OL).
These sheaths allow fast nerve transmission, protect axons and provide them metabolic support. In response to specific
traumas or pathologies, these lipid structures can be destabilized and generate demyelinating lesions. Multiple sclerosis
(MS) is an example of a demyelinating disease in which the myelin sheaths surrounding the nerve fibers of the brain and
spinal cord are damaged. MS is the leading cause of neurological disability in young adults in many countries, and its
incidence has been increasing in recent decades. Related to its etiology, it is known that MS is an autoimmune and
inflammatory CNS disease. However, there are no effective treatments for this disease and the immunomodulatory
therapies that currently exist have proven limited success since they only delay the progress of the disease. Nowadays, one
of the main goals in the MS research is to find treatments which allows the recovery of neurological disabilities due to
demyelination. To this end, different approaches, such as modulating intracellular signaling or regulating the lipid
metabolism of OLs, are being considered. Here, in addition to immunosuppressive or immunomodulatory drugs that
reduce the immune response against myelin sheaths, we review a diverse group of drugs that promotes endogenous
remyelination in MS patients and whose use may be interesting as potential therapeutic agents in MS disease. To this end,
we compile specific treatments against MS that are currently in the market with remyelination strategies which have
entered into human clinical trials for future reparative MS therapies. The method used in this study is a systematic
literature review on PubMed, Web of Science and Science Direct databases up to May 31, 2020. To narrow down the
search results in databases, more specific keywords, such as, “myelin sheath”, “remyelination”, “demyelination”,
“oligodendrocyte” and “lipid synthesis” were used to focus the search. We favoured papers published after January, 2015,
but did not exclude earlier seminal papers.
Evaluation of the effects of metformin as adenosine monophosphate-activated protein kinase activator on spatial learning and memory in a rat model of multiple sclerosis disease