The Department of Immunology, The Weizmann Institute of Science, Rehovot, Israel.
Expert Rev Neurother. 2010 Sep;10(9):1423-36. doi: 10.1586/ern.10.117.
The fundamental role of inflammatory immune processes in the pathology of multiple sclerosis (MS) provides the rationale for immunomodulatory therapies that attempt to shift the immune system from pro-inflammatory to anti-inflammatory pathways and induce regulatory mechanisms. Growing understanding of immune cellular and molecular mechanisms together with modern biotechnology engendered promising immunomodulatory treatment strategies, with novel mechanisms of actions and different levels of specificity. These include inhibitory molecules, monoclonal antibodies, cell therapies and agents that are administered orally or by infrequent infusions. Several of these treatments have demonstrated impressive efficacy in Phase II and III clinical trials by reducing disease activity and accumulation of disability. However, with the advent of potent therapies, rare but severe adverse effects, such as CNS infections and malignancies, have occurred. This article describes current and upcoming immunomodulatory strategies for MS therapy. The potential of immunomodulatory treatments to counteract the inflammatory characteristics of MS and support neuroprotective processes is discussed.
炎症免疫过程在多发性硬化症（MS）病理学中的基本作用为免疫调节治疗提供了依据，这些治疗试图将免疫系统从促炎途径转向抗炎途径，并诱导调节机制。对免疫细胞和分子机制的深入了解以及现代生物技术产生了有前途的免疫调节治疗策略，具有新颖的作用机制和不同的特异性水平。这些策略包括抑制分子、单克隆抗体、细胞疗法以及通过口服或不频繁输注给予的药物。其中一些治疗方法在 II 期和 III 期临床试验中通过降低疾病活动度和残疾累积已经显示出令人印象深刻的疗效。然而，随着强效治疗方法的出现，诸如中枢神经系统感染和恶性肿瘤等罕见但严重的不良反应也时有发生。本文描述了当前和即将出现的多发性硬化症治疗的免疫调节策略。讨论了免疫调节治疗对抗 MS 的炎症特征和支持神经保护过程的潜力。
