Mendes Amélia, Sá Maria José
Department of Neurology, Hospital de São João, Porto, Portugal.
Arq Neuropsiquiatr. 2011 Jun;69(3):536-43. doi: 10.1590/s0004-282x2011000400024.
Interferon beta (IFNβ) and glatiramer acetate (GA) were the first immunomodulators approved to the treatment of relapsing-remitting multiple sclerosis (MS) and clinically isolated syndromes. Despite the enlargement of the therapeutic armamentarium, IFNβ and GA remain the most widely drugs and the therapeutic mainstay of MS.
To review the mechanisms of action of IFNβ and GA and main clinical results in MS.
IFNβ modulates T and B-cell activity and has effects on the blood-brain barrier. The well proved mechanism of GA is an immune deviation by inducing expression of anti-inflammatory cytokines. Some authors favor the neuroprotective role of both molecules. Clinical trials showed a 30% reduction on the annualized relapse rate and of T2 lesions on magnetic resonance.
Although the precise mechanisms how IFNβ and GA achieve their therapeutics effects remain unclear, these drugs have recognized beneficial effects and possess good safety and tolerability profiles. The large clinical experience in treating MS patients with these drugs along almost two decades deserves to be emphasized, at a time where the appearance of drugs with more selective mechanisms of action, but potentially less safer, pave the way to a better selection of the most appropriate individualized treatment.
干扰素β（IFNβ）和醋酸格拉替雷（GA）是首批被批准用于治疗复发缓解型多发性硬化症（MS）和临床孤立综合征的免疫调节剂。尽管治疗手段有所增加，但IFNβ和GA仍然是应用最广泛的药物，也是MS的治疗支柱。
综述IFNβ和GA的作用机制以及在MS中的主要临床结果。
IFNβ调节T细胞和B细胞活性，并对血脑屏障有影响。GA已被充分证实的机制是通过诱导抗炎细胞因子的表达来实现免疫偏移。一些作者支持这两种分子的神经保护作用。临床试验表明，年化复发率和磁共振成像上的T2病灶减少了30%。
尽管IFNβ和GA实现其治疗效果的确切机制尚不清楚，但这些药物具有公认的有益作用，且安全性和耐受性良好。在出现作用机制更具选择性但潜在安全性较低的药物，为更好地选择最适合的个体化治疗铺平道路之际，值得强调的是，使用这些药物治疗MS患者已有近20年的丰富临床经验。
