Lopez-Diego Rocio S, Weiner Howard L
Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, Harvard Institute of Medicine Room 730, 77 Avenue Louis Pasteur, Boston, Massachusetts 02115, USA.
Nat Rev Drug Discov. 2008 Nov;7(11):909-25. doi: 10.1038/nrd2358.
Therapeutic strategies for multiple sclerosis have radically changed in the past 15 years. Five regulatory-approved immunomodulatory agents are reasonably effective in the treatment of relapsing-remitting multiple sclerosis, and appear to delay the time to progression to disabling stages. Inhibiting disease progression remains the central challenge for the development of improved therapies. As understanding of the immunopathogenesis of multiple sclerosis has advanced, a number of novel potential therapeutics have been identified, and are discussed here. It has also become apparent that traditional views of multiple sclerosis simply as a CD4+ T-cell-mediated disease of the central nervous system are incomplete. The pathogenic role of other immune components such as the innate immune system, regulatory T cells, T helper 17 cells and B cells is reaching centre stage, opening up exciting avenues and novel potential targets to affect the natural course of multiple sclerosis.
在过去15年中，多发性硬化症的治疗策略发生了根本性变化。五种获得监管批准的免疫调节药物在治疗复发缓解型多发性硬化症方面相当有效，并且似乎能延缓进展至致残阶段的时间。抑制疾病进展仍然是开发改进疗法的核心挑战。随着对多发性硬化症免疫发病机制的认识不断深入，已经确定了一些新的潜在疗法，并在此进行讨论。同样明显的是，将多发性硬化症简单地视为一种由CD4 + T细胞介导的中枢神经系统疾病的传统观点并不完整。其他免疫成分，如固有免疫系统、调节性T细胞、辅助性T细胞17和B细胞的致病作用正成为焦点，为影响多发性硬化症的自然病程开辟了令人兴奋的途径和新的潜在靶点。
