Blevins Gregg, Martin Roland
Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Building 10, Room 5B16, 10 Center Drive, Bethesda, MD 20892-1400, USA.
Semin Neurol. 2003 Jun;23(2):147-58. doi: 10.1055/s-2003-41137.
Immunotherapy of multiple sclerosis (MS) will continue to benefit from an increasing understanding of this disease. This knowledge results in newly defined targets for novel therapies. In this article the development of future immunotherapies will be discussed by classifying the approaches into three main types: (1) antigen-specific therapies; (2) agents with a defined target in pathogenic steps of the MS lesion; and (3) therapies with broad immunomodulatory activity. Success in developing new immunotherapies depends on understanding the underlying complexity and heterogeneity of the disease. The current practice of employing a single therapy across a heterogeneous group of MS patients is in part a likely reason for their modest efficacy. The mechanism of action of a single agent may target the appropriate defect in one individual but not others. The therapy of MS in the future will most likely use a combination of agents that are directed at the underlying disease state and stage in the individual patient.
对多发性硬化症（MS）的免疫疗法将继续受益于对该疾病日益深入的了解。这些知识为新型疗法带来了新定义的靶点。在本文中，未来免疫疗法的发展将通过将方法分为三种主要类型来进行讨论：（1）抗原特异性疗法；（2）在MS病变致病步骤中有明确靶点的药物；（3）具有广泛免疫调节活性的疗法。开发新免疫疗法的成功取决于对疾病潜在复杂性和异质性的理解。目前在一组异质性MS患者中采用单一疗法的做法，部分可能是其疗效一般的原因。单一药物的作用机制可能针对一个个体的适当缺陷，但对其他个体则不然。未来MS的治疗很可能会使用针对个体患者潜在疾病状态和阶段的多种药物组合。
