Compston A
Department of Clinical Neurosciences, University of Cambridge Clinical School, Cambridge, UK.
Acta Neurol Scand Suppl. 2006;183:41-7. doi: 10.1111/j.1600-0404.2006.00614.x.
Contemporary licensed treatments for multiple sclerosis fail to provide a solution for the disease because their effects are limited to a modest reduction in the frequency of new episodes. They do not reduce disability or materially influence the progressive phase of the disease. A contemporary strategy for management requires a more detailed analysis of the separate contributions to the clinical features and overall course made by inflammation, axonal injury, compensatory mechanisms, and remyelination. From this formulation emerges the need either for early and fully effective suppression of the inflammatory response, limiting the damage to all components of the axon-glial unit; or the development of strategies for axonal and myelin repair that solve the issues of controlled differentiation, delivery and timing of these cell and growth factor-based interventions.
目前获批用于治疗多发性硬化症的疗法无法解决该疾病，因为其效果仅限于适度降低新发病例的频率。它们无法减轻残疾程度，也无法对疾病的进展阶段产生实质性影响。当前的治疗策略需要更详细地分析炎症、轴突损伤、代偿机制和髓鞘再生对临床特征和疾病全过程的不同作用。由此得出，要么需要尽早并全面有效地抑制炎症反应，限制对轴突 - 神经胶质单元所有成分的损害；要么需要制定轴突和髓鞘修复策略，解决基于细胞和生长因子的干预措施的可控分化、递送和时机问题。
