MS-Perspektive - The Multiple Sclerosis Podcast24 Dec 2025

#146: What is Chronic Smoldering Inflammation in Multiple Sclerosis? With Dr. Klarissa Hanja Stürner

This episode was supported by Sanofi S.A.

In this episode, I speak with Dr. Klarissa Hanja Stürner about chronic smoldering inflammation in multiple sclerosis (MS)—a slow, often hidden process that may drive disease progression even when relapses and MRI activity appear stable.

Dr. Stürner explains how chronic inflammation behind the blood–brain barrier differs from acute relapse-related inflammation, why it is so difficult to detect with current imaging, and which warning signs people with MS should take seriously. We also discuss PIRA (Progression Independent of Relapse Activity), the role of microglia and macrophages, and why new treatment approaches such as BTK inhibitors are considered a promising step forward in MS research.

This episode offers a clear, evidence-based, and hopeful perspective for anyone who wants to better understand MS progression beyond relapses.

📝 Read the full article on the MS-Perspective blog for a detailed written summary of the conversation: https://ms-perspektive.de/EN/146-dr-stuerner

Topics covered in this episode

What chronic smoldering inflammation in MS means
Differences between acute relapses and smoldering inflammation
Inflammation behind the blood–brain barrier
Why MRI often fails to detect these processes
Clinical red flags for progression without relapses
PIRA explained in simple terms
The role of microglia and macrophages in MS
BTK inhibitors as a new therapeutic approach
Current challenges and future directions in MS research

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Many thanks to Dr. Stürner for the insightful interview and this positive outlook on the present and the future.

See you soon and try to make the best out of your life,
Nele

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