Comi G, Martino G
Centro de Esclerosis Múltiple, Instituto Científico San Rafael, Milán, Italia.
Rev Neurol. 2000;30(12):1265-8.
Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) of unknown etiology. Its pathological hallmark is the presence within the CNS of inflammatory infiltrates containing few autoreactive T cells and a multitude of pathogenic nonspecific lymphocytes. Based on that, various non-specific immunosuppressive agents have been tested with marginal benefits on the natural evolution of the disease and frequent short- and long-term adverse effects. Moreover, due to their unfavourable profile, these therapies have been usually limited to patients with progressive courses or high clinical activity. The recent approval of IFN beta and Copolymer 1, as therapies able to modify the disease course in relapsing-remitting and secondary progressive, as well as the available immunopathological and clinical data suggesting that the early treatment of MS with safe profile immunomodulatory drugs could be advantageous compared to late treatments, supports the 'putative' relevance of these new drugs in the early treatment of MS patients. However we must wait for the results of ongoing clinical trials to define if such an early treatment has substantial advantages compared to late treatment.
多发性硬化症（MS）是一种病因不明的中枢神经系统（CNS）脱髓鞘疾病。其病理标志是在中枢神经系统内存在炎症浸润，其中含有少量自身反应性T细胞和大量致病性非特异性淋巴细胞。基于此，各种非特异性免疫抑制剂已被测试，对疾病的自然发展仅有有限益处，且常伴有短期和长期的不良反应。此外，由于其不良特性，这些疗法通常仅限于病程进展型或临床活动度高的患者。近期，干扰素β和共聚物1获批用于治疗复发缓解型和继发进展型多发性硬化症，能够改变疾病进程，同时现有的免疫病理学和临床数据表明，与晚期治疗相比，使用安全性良好的免疫调节药物早期治疗MS可能更具优势，这支持了这些新药在MS患者早期治疗中的“假定”相关性。然而，我们必须等待正在进行的临床试验结果，以确定这种早期治疗与晚期治疗相比是否具有实质性优势。
