Clinical Neuroinflammation and Neurodegeneration
Our group studies immune-mediated diseases of the nervous system, particularly multiple sclerosis (MS) and myasthenia gravis (MG). Although our research has contributed to treatment development in both conditions, our current programme is primarily focused on MS.
We aim to improve the benefit–risk balance of therapeutic interventions, understand the mechanisms underlying inflammatory and progressive disease, and develop biomarkers that reflect the underlying biology and can support treatment decisions.
About our research
MS is an immune-mediated disease in which inflammation causes damage to myelin, nerve fibres and other cells of the central nervous system. Modern treatments can strongly suppress relapses and new inflammatory lesions. However, some people continue to accumulate disability despite good control of conventional inflammatory disease activity. Understanding and treating this progression is therefore a central challenge.
Our research is closely integrated with clinical care and combines randomised clinical trials, prospective cohorts, nationwide health registers, advanced magnetic resonance imaging (MRI), immune profiling, and molecular analyses of blood and cerebrospinal fluid. By linking these different data sources, we seek to connect treatment outcomes with the biological mechanisms that drive disease.
People living with MS are important partners in our research, from participation in longitudinal studies and clinical trials to helping us identify clinically relevant questions and outcomes.
Main research themes
Improving the benefit–risk balance of MS treatments
A major part of our research concerns how immunomodulatory treatments can be used more effectively and safely. We conduct randomised trials and large observational studies comparing treatment effectiveness, adverse events, treatment persistence and patient-reported outcomes. B-cell-depleting therapies are an important focus. Our studies have examined rituximab and ocrelizumab, extended treatment intervals, infection risk, immunoglobulin levels and other factors that may help individualise treatment. This work includes the COMBAT-MS programme and several investigator-initiated clinical trials.
Inflammatory and progressive disease mechanisms
We study how B cells, T cells, myeloid cells and other immune mechanisms contribute to inflammation and tissue injury in MS. We are particularly interested in why disability may progress independently of relapses and new focal MRI lesions. Our work addresses compartmentalised inflammation within the central nervous system, glial and neuroaxonal injury, remyelination, host–virus interactions and the biological consequences of long-term immunomodulatory treatment. The overall aim is to identify mechanisms that can be targeted in people whose disease continues to progress despite effective control of acute inflammation.
Biomarkers reflecting disease biology
We develop and evaluate biomarkers that can describe the biological processes underlying an individual’s disease. These include soluble biomarkers such as neurofilament light protein and glial fibrillary acidic protein, immune-cell phenotypes, genomic and epigenomic measures, and quantitative MRI markers. We increasingly integrate high-dimensional molecular data with AI-based analysis of conventional, 3-tesla and 7-tesla MRI. Our aim is to identify biomarkers that can improve prognosis, monitor treatment effects and adverse consequences, and serve as biologically meaningful outcomes in clinical trials.
Clinical trials
Our group has led several investigator-initiated MS treatment trials, including RIFUND-MS, RIDOSE-MS and OVERLORD-MS. These studies have evaluated early high-efficacy treatment, extended dosing intervals and head-to-head comparisons of B-cell-depleting therapies. We have also conducted innovative trials specifically addressing progression despite effective control of relapsing disease. ProTEct-MS evaluated an add-on treatment strategy in people whose disability progressed despite rituximab therapy.
In 2026, we initiated MSBenefiT, an investigator-initiated randomised trial comparing the brain-penetrant BTK inhibitor tolebrutinib with continued rituximab in people with progression despite long-term B-cell-depleting treatment. The study integrates clinical outcomes with advanced MRI and biomarkers in blood and cerebrospinal fluid.
ProTEct-MS and MSBenefiT were developed through collaboration between academia and the pharmaceutical industry. We also participate in international, multicentre clinical trials evaluating emerging treatments for MS.
Strategic collaborations
Our research is based on long-term strategic collaborations across complementary fields. At Karolinska Institutet, close partners include the groups of Thomas Frisell in clinical epidemiology, Maja Jagodic in functional genomics and neuroimmunology, and Tobias Granberg in quantitative and AI-based neuroimaging. Important international collaborations include Øivind Torkildsen and the MS Centre in Bergen, and the MS Center at University Hospital Basel. These collaborations form part of a broader national and international network of academic researchers, clinicians, patient representatives and industry partners.
By combining complementary expertise, large clinical cohorts and detailed biological data, we aim to translate mechanistic knowledge into safer, more effective and more individualised treatment strategies for people with MS.
Research Projects
- Experimental clinical studies on neuroimmunology, and imaging and soluble biomarkers in MS, and other inflammatory and non-inflammatory conditions.
- Clinical treatment research in MS.
- Clinical treatment research in MG.
